Individual provider Active NPI

Jolomi T Ikomi, M.D

  • Psychiatry Physician
  • Wilmington, DE
National Provider Identifier
1396911640
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
C1-0012194 Issued in DE
Practice address
501 W 14TH St Ste 3N74
Wilmington, DE 19801-1013
Phone
(302) 320-2963
Fax
(302) 320-4934
NPI assigned
May 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Psychiatry Physician 2084P0802X C1-0012194 DE
Psychiatry Physician 2084P0800X C1-0012194 DE Primary

Addresses

Primary practice location

501 W 14TH St Ste 3N74
Wilmington, DE 19801-1013

Mailing address

501 W 14TH St Ste 3N74
Wilmington, DE 19801-1013
Phone (513) 536-4673

Other identifiers 5

IdentifierTypeStateIssuer
008003745MedicaidCT
004041000MedicaidCT
008043119MedicaidCT
004217099MedicaidCT
008039745MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20170817003682 DE Practitioner - PsychiatryPractitioner - Addiction Medicine 7113065343 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Addiction Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Christiana Care Health Services IncGroup PAC ID 9739097569, 1,480 clinicians
Christiana Care Health InitiativesGroup PAC ID 2466351481, 33 clinicians

Practice addresses (Care Compare)

100 Sunnyside Rd
Smyrna, DE 19977-1752
Phone (302) 653-1900

501 W 14TH St
Wilmington, DE 19801-1013

501 W 14TH St FL
6 CCHS Infectious Disease
Wilmington, DE 19801-1013
Phone (302) 320-1300

501 W 14TH St Wilmington Hospital
Wilmington, DE 19801-1013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services Inc CurrentSince Aug 13, 2017 Accepting new patients
Christiana Care Health Initiatives Current Accepting new patients
Christiana Care Health Initiatives CurrentSince Sep 1, 2019 Accepting new patients
Christiana Care Health Services, Inc Psychiatry CurrentSince Aug 13, 2017 Accepting new patients
Christiana Care Health Services, Inc Current Accepting new patients
Christiana Care Health Initiatives CurrentSince Sep 1, 2019 Accepting new patients
Paramount Mental Healthcare PLLC Psychiatry Current Accepting new patients
Christiana Care Health Services, Inc PastSince Jul 24, 2022 Accepting new patients
Ria Health PC Addiction Psychiatry Past Accepting new patients
Christiana Care Health Services Inc Past Accepting new patients

Locations

100 Sunnyside Rd
#2
Smyrna, DE 19977
Phone (302) 653-1900

501 W 14th St
Ste 3N74
Wilmington, DE 19801
Phone (302) 320-2963

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

501 W 14th St
Ste 1E40
Wilmington, DE 19801
Phone (302) 320-2100

Interoperability endpoints

  • Direct secure messaging: jolomi.ikomi.1@16211.direct.athenahealth.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/5c7467fb-60f9-4172-add4-57667a5dfcfa/

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1396911640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 W 14TH ST STE 3N74",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198011013",
            "telephone_number": "513-536-4673",
            "fax_number": "513-536-0609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W 14TH ST STE 3N74",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198011013",
            "telephone_number": "302-320-2963",
            "fax_number": "302-320-4934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKOMI",
        "first_name": "JOLOMI",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "DE",
            "license": "C1-0012194",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "DE",
            "license": "C1-0012194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008003745",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004041000",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008043119",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004217099",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008039745",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.