Individual provider Active NPI

Bolaji O Onabajo, MD

  • Internal Medicine Physician
  • Glen Burnie, MD
National Provider Identifier
1295718526
Registry record updated Jun 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0045149 Issued in MD
Practice address
301 Hospital Dr
Glen Burnie, MD 21061-5803
Phone
(410) 787-4000
NPI assigned
Nov 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0045149 MD Primary

Addresses

Primary practice location

301 Hospital Dr
Glen Burnie, MD 21061-5803

Mailing address

PO Box 512650
Philadelphia, PA 19175-2650

Other identifiers 7

IdentifierTypeStateIssuer
5226OtherMDBRAVO/ELDER HEALTH
5713318OtherMDCIGNA
130441100MedicaidMD
2266876OtherMDAETNA HMO
109200OtherMDJOHNS HOPKINS HEALTH CARE
5384548OtherMDAETNA PPO
F551-0007OtherDCCARE FIRST BLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20100107000285 MD Practitioner - Internal Medicine 3678614054 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0045149MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Community Medical Group, Inc. CurrentSince Jan 1, 2016 Accepting new patients
Baltimore Washington Medical Center Inc. Current Accepting new patients
Baltimore Washington Medical Center Inc. Current Accepting new patients
Baltimore Washington Medical Center Inc. Internal Medicine CurrentSince Jan 1, 1996 Accepting new patients
University of Maryland Community Medical Group, Inc. CurrentSince Jan 1, 2016 Accepting new patients
Baltimore Washington Medical Center Inc. CurrentSince Jan 1, 1996 Accepting new patients
Arundel Physicians Associates, LLC Internal Medicine Past Accepting new patients
Baltimore Washington Emergency Physicians, Inc. Past Accepting new patients
Baltimore Washington Professional Services Inc. Past Accepting new patients

Locations

2540 Centreville Rd
Centreville, MD 21617
Phone (410) 758-4432

219 S Washington St
Easton, MD 21601

300 Hospital Dr
Ste 132
Glen Burnie, MD 21061
Phone (410) 255-1600

301 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4565

300 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4940

Interoperability endpoints

  • Direct secure messaging: bonabajo23318@direct.umm.edu

Organizations & group practices 9

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

NPI Registry JSON

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244073600000",
    "number": "1295718526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 512650",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191752650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HOSPITAL DR",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615803",
            "telephone_number": "410-787-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONABAJO",
        "first_name": "BOLAJI",
        "middle_name": "O",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2009-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0045149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRAVO/ELDER HEALTH",
            "identifier": "5226",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5713318",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130441100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2266876",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHNS HOPKINS HEALTH CARE",
            "identifier": "109200",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "5384548",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE FIRST BLUE CROSS",
            "identifier": "F551-0007",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

Verify at the official NPI Registry.