Individual provider Active NPI

Igbayilola Mariam Dosunmu, MD

  • Internal Medicine Physician
  • Plantation, FL
National Provider Identifier
1487232369
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME167632 Issued in FL
Practice address
8201 W Broward Blvd
Plantation, FL 33324-2701
Phone
(877) 832-2652
Fax
(800) 792-9021
NPI assigned
Mar 31, 2021
Last updated
Jul 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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
Internal Medicine Physician 207R00000X ME167632 FL Primary

Addresses

Primary practice location

8201 W Broward Blvd
Plantation, FL 33324-2701

Mailing address

1521 S Staples St Ste 606
Corpus Christi, TX 78404-3166
Phone (877) 832-2652

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240805003126 FL Practitioner - Internal Medicine 9133666464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HHA Associates LLCGroup PAC ID 2961839758, 125 clinicians

Practice addresses (Care Compare)

8201 W Broward Blvd
Plantation, FL 33324-2701
Phone (954) 476-3911

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
HHA Associates LLC CurrentSince Jul 1, 2024 Accepting new patients
Elite Care MD LLC Internal Medicine Current Accepting new patients

Locations

3476 S University Dr
Davie, FL 33328
Phone (954) 475-4350

8201 W Broward Blvd
Plantation, FL 33324
Phone (954) 476-3900

7201 N University Dr
Tamarac, FL 33321
Phone (954) 721-2200

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

Hospital & facility affiliations 1

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": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1487232369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 S STAPLES ST STE 606",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784043166",
            "telephone_number": "877-832-2652",
            "fax_number": "361-371-8376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8201 W BROWARD BLVD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242701",
            "telephone_number": "877-832-2652",
            "fax_number": "800-792-9021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOSUNMU",
        "first_name": "IGBAYILOLA",
        "middle_name": "MARIAM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-31",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME167632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.