Individual provider Active NPI

Toluwalope Akinade Makinde, MD

  • Family Medicine Physician
  • Bryn Mawr, PA
National Provider Identifier
1457903783
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MT219084 Issued in PA
Practice address
135 S Bryn Mawr Ave Ste 200
Bryn Mawr, PA 19010-3129
Phone
(610) 325-1390
NPI assigned
Jul 16, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MT219084 PA Primary

Addresses

Primary practice location

135 S Bryn Mawr Ave Ste 200
Bryn Mawr, PA 19010-3129

Mailing address

4920 City Avenue
A509 Bala Apartments
Philadelphia, PA 19131
Phone (647) 648-7687

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20190814003888 PA Order and Referring Only - Family PracticePractitioner - Family Practice 0840527784

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare Family Medicine CurrentSince Jul 25, 2019 Accepting new patients
Athens Nutrition, LLC PastSince Jul 25, 2019 Accepting new patients

Locations

135 S Bryn Mawr Ave
Ste 200
Bryn Mawr, PA 19010
Phone (610) 325-1390

Organizations & group practices 2

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": "1563235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1457903783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4920 CITY AVENUE",
            "address_2": "A509 BALA APARTMENTS",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19131",
            "telephone_number": "647-648-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 S BRYN MAWR AVE STE 200",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103129",
            "telephone_number": "610-325-1390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKINDE",
        "first_name": "TOLUWALOPE",
        "middle_name": "AKINADE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-16",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MT219084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

Verify at the official NPI Registry.