Active NPI
Babatunde Bamidele, RN
- Critical Care Medicine Registered Nurse
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine Registered Nurse
- License
- 831990
- Practice address
- 2051 Marengo St
Los Angeles, CA 90033-1352 - Phone
- (323) 409-1000
- NPI assigned
- Sep 4, 2018
- Last updated
- Jan 4, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine Registered Nurse | 163WC0200X | 831990 | CA | Primary |
Addresses
Primary practice location
2051 Marengo St
Los Angeles, CA 90033-1352
Mailing address
2725 Fairgreen Ave
Arcadia, CA 91006-5022
Phone (832) 407-1410
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 831990 | CA | MD | Critical Care Medicine Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Farnad Medical Corporation | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Northridge Pain Management Specialists Medical Corporation | Current | Accepting new patients |
Locations
5757 Wilshire Blvd
Ste PR2
Los Angeles, CA 90036
Phone (310) 285-9612
6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000
8331 Reseda Blvd
Northridge, CA 91324
Phone (818) 724-5979
393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235
Organizations & group practices 5
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672790400000",
"number": "1316429517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2725 FAIRGREEN AVE",
"city": "ARCADIA",
"state": "CA",
"postal_code": "910065022",
"telephone_number": "832-407-1410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2051 MARENGO ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900331352",
"telephone_number": "323-409-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAMIDELE",
"first_name": "BABATUNDE",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-04",
"last_updated": "2023-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "CA",
"license": "831990",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "6041 Cadillac Ave",
"city": "Los Angeles",
"state": "CA",
"country_code": "US",
"postal_code": "900341702",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.