Individual provider Active NPI

Oluwatoyin Moyebi, MD/MPH

  • Internal Medicine Physician
  • Gallup, NM
National Provider Identifier
1316579352
Registry record updated Nov 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD2023-0296 Issued in NM
Practice address
1901 Red Rock Dr
Gallup, NM 87301-5683
Phone
(505) 863-7000
Fax
(505) 863-7330
NPI assigned
Feb 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X MD2023-0296 NM Primary

Addresses

Primary practice location

1901 Red Rock Dr
Gallup, NM 87301-5683

Mailing address

1700 Grand Concourse Apt 15G
Bronx, NY 10457-7659

Other practice location 1

1650 Grand Concourse
Bronx, NY 10457-7697
Phone (718) 901-8043

Other names 1

  • Oluwatoyin Erinle Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230710003262 NM Practitioner - Hospitalist 4789043639 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehoboth McKinley Christian Health Care Services, Inc.Group PAC ID 1759293855, shared by 3 NPIs, 31 clinicians

Practice addresses (Care Compare)

1901 Red Rock Dr
Gallup, NM 87301-5683
Phone (505) 863-7000

Hospital & facility affiliations

  • Rehoboth McKinley Christian Health Care Services Hospital, Gallup, NM, CCN 321313
  • Gallup Indian Medical Center Hospital, Gallup, NM, CCN 320061

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2023-0296NMMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rehoboth McKinley Christian Health Care Services, Inc CurrentSince Jun 1, 2023 Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc Internal Medicine CurrentSince Jun 1, 2023 Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc. Current Accepting new patients

Locations

1901 Red Rock Dr
Gallup, NM 87301
Phone (505) 863-7000

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1581033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699574400000",
    "number": "1316579352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 GRAND CONCOURSE APT 15G",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104577659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 RED ROCK DR",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015683",
            "telephone_number": "505-863-7000",
            "fax_number": "505-863-7330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1650 Grand Concourse",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104577697",
            "country_code": "US",
            "telephone_number": "718-901-8043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOYEBI",
        "first_name": "OLUWATOYIN",
        "name_prefix": "Dr.",
        "credential": "MD/MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-07",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "MD2023-0296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLUWATOYIN",
            "last_name": "ERINLE",
            "credential": "MD/MPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gallup, NM

Sources for this page

Verify at the official NPI Registry.