Individual provider Active NPI

Anthony Ogundipe

  • Maternal & Fetal Medicine Physician
  • Lynwood, CA
National Provider Identifier
1316027360
Registry record updated Dec 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
G64561 Issued in CA
Practice address
3628 E Imperial Hwy
Ste 200
Lynwood, CA 90262-2646
Phone
(310) 603-2345
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X G64561 CA Primary

Addresses

Primary practice location

3628 E Imperial Hwy
Ste 200
Lynwood, CA 90262-2646

Mailing address

3628 E Imperial Hwy
Ste 200
Lynwood, CA 90262-2646

Other identifiers 1

IdentifierTypeStateIssuer
00G645612MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20110214000113 CA Practitioner - Obstetrics/GynecologyPractitioner - Other (Physician) 3779763461 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Howard University College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3628 E Imperial Hwy
Suite 200
Lynwood, CA 90262-2646
Phone 31060323456

401 W Manchester Blvd
Inglewood, CA 90301-1109
Phone (310) 672-2288

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G64561CAMDMaternal & Fetal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Maternal & Fetal Medicine CurrentSince Oct 1, 2021 Accepting new patients
St Francis Medical Center Past Accepting new patients
Prime Healthcare Centinela, LLC Past Accepting new patients
Maternal-Fetal Medicine Associates Maternal & Fetal Medicine Past Accepting new patients
Martin Luther King, Jr. - Los Angeles (MLK-la) Healthcare Corporation Past Accepting new patients
Maternal-Fetal Medicine Associates Maternal & Fetal Medicine Past Accepting new patients

Locations

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

200 S Manchester Ave
Ste 300
Orange, CA 92868
Phone (714) 424-9001

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 8

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292457600000",
    "number": "1316027360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3628 E IMPERIAL HWY",
            "address_2": "STE 200",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3628 E IMPERIAL HWY",
            "address_2": "STE 200",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622646",
            "telephone_number": "310-603-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUNDIPE",
        "first_name": "ANTHONY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2010-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "CA",
            "license": "G64561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G645612",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynwood, CA

Sources for this page

Verify at the official NPI Registry.