Individual provider Active NPI

Opeyemi Ayotunde Ibidapo, MD

  • Student in an Organized Health Care Education/Training Program
  • New York, NY
National Provider Identifier
1336371384
Registry record updated Jun 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
550 First Avenue
NYU Langone Medical Center
New York, NY 10016-6402
Phone
(212) 263-5506
Fax
(212) 263-5506
NPI assigned
Aug 10, 2009
Last updated
Jun 20, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2011

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 NU Primary
Internal Medicine Physician 207R00000X P24246 MD

Addresses

Primary practice location

550 First Avenue
NYU Langone Medical Center
New York, NY 10016-6402

Mailing address

550 First Avenue
NYU Langone Medical Center
New York, NY 10016-6402
Phone (212) 263-5506

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
I20160510000783 MD Practitioner - Diagnostic Radiology 6709175029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Virginia School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Radiology P aGroup PAC ID 1254327950, 155 clinicians

Practice addresses (Care Compare)

104 Plumtree Rd
Bel Air, MD 21015-6095

116 Defense Hwy
Suite Ll100
Annapolis, MD 21401-7626
Phone (888) 972-9700

11810 W Market PL
Fulton, MD 20759-2703
Phone (888) 972-9700

1209 York Rd
Suite 100
Lutherville, MD 21093-6208
Phone (888) 972-9700

122 Defense Hwy
Suite 102
Annapolis, MD 21401-7044
Phone (888) 972-9700

124 Sister Pierre Dr
Towson, MD 21204-7507
Phone (888) 972-9700

1430 Progress Way
Suite 108
Eldersburg, MD 21784-6484
Phone (888) 972-9700

1600 Crain Hwy S
Suite 101
Glen Burnie, MD 21061-6440
Phone (888) 972-9700

1700 Reisterstown Rd
Baltimore, MD 21208-2935

200 Hospital Dr
Suite Ll20And112
Glen Burnie, MD 21061-5884
Phone (888) 972-9700

201 Plumtree Rd
Suite 101
Bel Air, MD 21015-6055
Phone (888) 972-9700

203 Hospital Dr
Suite 100
Glen Burnie, MD 21061-6904
Phone (888) 972-9700

2080 York Rd
Suite 160
Timonium, MD 21093-4249
Phone (888) 972-9700

21 Crossroads Dr
Suite 120
Owings Mills, MD 21117-5497
Phone (888) 972-9700

301 Hospital Dr
Glen Burnie, MD 21061-5803
Phone (888) 972-9700

4211 Blakely Ave
Baltimore, MD 21236-2456

4801 Dorsey Hall Dr
Ellicott City, MD 21042-7703

500 Upper Chesapeake Dr
Bel Air, MD 21014-4324
Phone (888) 972-9700

5500 Knoll N Dr
Suite 100
Columbia, MD 21045-2360
Phone (888) 972-9700

650 McHenry Rd
Suite 1400
Aberdeen, MD 21001-2607
Phone (443) 718-8709

6565 N Charles St
Suite 100
Baltimore, MD 21204-6807
Phone (888) 972-9700

6715 N Charles St
Suite 250
Towson, MD 21204-6822
Phone (888) 972-9700

7501 Osler Dr
Towson, MD 21204-7743
Phone (888) 972-9700

7801 Elvaton CT
Glen Burnie, MD 21061-6763
Phone (888) 972-9700

8601 Veterans Hwy
Suite 100
Millersville, MD 21108-1571
Phone (888) 972-9700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.33 of 100Reported as group
Quality
63.33
Promoting interoperability
100
Improvement activities
40
Cost
74.44

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P24246MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Diagnostic Radiology, LLC Current Accepting new patients
Advanced Radiology P a CurrentSince May 1, 2016 Accepting new patients
Advanced Radiology P a CurrentSince May 1, 2016 Accepting new patients

Locations

26999 Network Pl
Chicago, IL 60673

500 Upper Chesapeake Dr
Bel Air, MD 21014
Phone (443) 643-1000

4801 Dorsey Hall Dr
Ste 101
Ellicott City, MD 21042
Phone (443) 436-1600

7253 Ambassador Rd
Windsor Mill, MD 21244
Phone (410) 281-9191

Interoperability endpoints

  • Direct secure messaging: oibidapo651670@direct.umm.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1249862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308528000000",
    "number": "1336371384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 FIRST AVENUE",
            "address_2": "NYU LANGONE MEDICAL CENTER",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "212-263-5506",
            "fax_number": "212-263-5506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 FIRST AVENUE",
            "address_2": "NYU LANGONE MEDICAL CENTER",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "212-263-5506",
            "fax_number": "212-263-5506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBIDAPO",
        "first_name": "OPEYEMI",
        "middle_name": "AYOTUNDE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-10",
        "last_updated": "2011-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "P24246",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.