Active NPI
Ibukunola Olaitan Adediji, PA
- Internal Medicine Physician
- Baltimore, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- C0007794
- Practice address
- 9000 Franklin Square Dr
Baltimore, MD 21237-3901 - Phone
- (443) 777-7000
- NPI assigned
- Dec 4, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | C0007794 | MD | Primary |
Addresses
Primary practice location
9000 Franklin Square Dr
Baltimore, MD 21237-3901
Mailing address
2939 Siwanoy Dr
Edgewood, MD 21040-3436
Phone (443) 616-8554
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD, DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1307 Merritt Blvd
Dundalk, MD 21222-2109
Phone (410) 288-2121
1354 Eastern Blvd
Expresscare of Essex
Essex, MD 21221-3423
Phone (443) 231-5203
1470 Martin Blvd
Middle River, MD 21220-4105
Phone (443) 231-5203
1505 E Churchville Rd
Bel Air, MD 21014-4742
2006 Rock Spring Rd
Forest Hill, MD 21050-2607
Phone (410) 569-0044
2401 E Belvedere Ave
Baltimore, MD 21215-5216
4009 N Point Blvd
105 Expresscare of North Point
Dundalk, MD 21222-3619
Phone (410) 477-1039
5 Bel Air S Pkwy
Suite 1535
Bel Air, MD 21015-3816
Phone (410) 569-0044
7700 Belair Rd
Baltimore, MD 21236-4004
Phone (410) 665-0670
7701 Harford Rd
Parkville, MD 21234-6403
Phone (410) 569-0069
8000 Loch Raven Blvd
Loch Raven, MD 21286-8337
Phone (410) 616-9027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C0007794 | MD | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MNR Industries LLC | Current | Accepting new patients | |
| MNR Industries, LLC | Current | Accepting new patients | |
| MNR Industries, LLC | Current | Accepting new patients | |
| MNR Industries, LLC | Current | Accepting new patients |
Locations
1505 E Churchville Rd
#A
Bel Air, MD 21014
Phone (410) 420-6970
1505 E Churchville Rd
Bel Air, MD 21014
Phone (410) 420-6970
6000 Laurel Bowie Rd
Bowie, MD 20715
Phone (301) 383-0330
504 E Ridgeville Blvd
#A
Mount Airy, MD 21771
Phone (301) 703-5452
Organizations & group practices 7
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.
-
- Urgent Care Clinic/Center
- Bel Air, MD
- NPI 1457478703
-
- General Practice Physician
- Baltimore, MD
- NPI 1184046187
-
- Urgent Care Clinic/Center
- Mount Airy, MD
- NPI 1073963146
-
- Urgent Care Clinic/Center
- Upper Marlboro, MD
- NPI 1194195008
-
- Urgent Care Clinic/Center
- Bel Air, MD
- NPI 1649089418
-
- Urgent Care Clinic/Center
- Randallstown, MD
- NPI 1902262587
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607040000000",
"number": "1386240455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2939 SIWANOY DR",
"city": "EDGEWOOD",
"state": "MD",
"postal_code": "210403436",
"telephone_number": "443-616-8554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9000 FRANKLIN SQUARE DR",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212373901",
"telephone_number": "443-777-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADEDIJI",
"first_name": "IBUKUNOLA",
"middle_name": "OLAITAN",
"name_prefix": "Mrs.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-04",
"last_updated": "2020-12-04",
"certification_date": "2020-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MD",
"license": "C0007794",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.