Uwayemwen Ogbonmwonkpa Aideyan, MD

Individual provider Active NPI Pediatric Radiology Physician · Jacksonville, FL

NPI 1295738425 · NPPES record last updated Mar 7, 2023

Key facts

NPI
1295738425
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Radiology Physician 2085P0229X
License
ME69757 (FL)
Practice address
807 Children'S Way
Jacksonville, FL 32207-8426
Phone
(904) 390-3600
Fax
(904) 390-3592
NPI assigned
May 23, 2005
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise Medical Group Inc Diagnostic Radiology Past Accepting new patients
Radiology Associates of Hollywood, Inc. Diagnostic Radiology Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13023/brand/4/csg/1/fhir/r4

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology Physician 2085P0229X ME69757 FL Yes
Diagnostic Radiology Physician 2085R0202X ME69757 FL

Addresses

Primary practice location

807 Children'S Way
Jacksonville, FL 32207-8426

Mailing address

PO Box 5270
Jacksonville, FL 32247-5720
Phone (904) 288-5650

Other identifiers

IdentifierTypeStateIssuer
300132744OtherFLRAILROAD MEDICARE
28338OtherFLAVMED
28338OtherFLBLUE CROSS BLUE SHIELD
379203000MedicaidFL

Other names

  • Uwa Aideyan-Alexis Former name

Other providers in Jacksonville, FL

All providers in Jacksonville, FL · Pediatric Radiology Physician in Florida

Sources for this page

Verify at the official NPI Registry.