Individual provider Active NPI

Bolanle Ariyo, D.O.

  • Family Medicine Physician
  • Washington, DC
National Provider Identifier
1265669840
Registry record updated Jan 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO034403 Issued in DC
Practice address
3720 Martin Luther King Jr Ave SE
Washington, DC 20032-1548
Phone
(202) 279-1800
NPI assigned
Jun 22, 2009
Last updated
Jan 18, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO034403 DC Primary

Addresses

Primary practice location

3720 Martin Luther King Jr Ave SE
Washington, DC 20032-1548

Mailing address

3801 Georgia Ave NW
Apt. 302
Washington, DC 20011-5897

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130212000410 DC Practitioner - Family Practice 5698929065 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO034403DCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unity Health Care, Inc. CurrentSince Oct 16, 2012 Accepting new patients
Unity Health Care Inc. CurrentSince Oct 16, 2012 Accepting new patients

Locations

1310 Southern Ave SE
Washington, DC 20032
Phone (202) 574-6000

3720 Martin Luther King Jr Ave SE
Washington, DC 20032
Phone (202) 279-1800

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358467200000",
    "number": "1265669840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 GEORGIA AVE NW",
            "address_2": "APT. 302",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200115897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 MARTIN LUTHER KING JR AVE SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200321548",
            "telephone_number": "202-279-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARIYO",
        "first_name": "BOLANLE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-22",
        "last_updated": "2013-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DC",
            "license": "DO034403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.