Individual provider Active NPI

Ebenezer O. Oloyede, MD, MPH

  • Internal Medicine Physician
  • Annapolis, MD
National Provider Identifier
1528697976
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0097802 Issued in MD
Practice address
2003 Medical Pkwy Ste 350
Annapolis, MD 21401-3081
Phone
(443) 951-4286
Fax
(443) 949-7380
NPI assigned
Apr 7, 2020
Last updated
Aug 2, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101279846 VA
Internal Medicine Physician 207R00000X D0097802 MD Primary

Addresses

Primary practice location

2003 Medical Pkwy Ste 350
Annapolis, MD 21401-3081

Mailing address

2003 Medical Pkwy Ste 350
Annapolis, MD 21401-3081
Phone (443) 951-4286

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240314003873 VA Practitioner - Internal Medicine 1951718519 Reassigns benefits to 1 organization
I20240417001788 DC Practitioner - Internal Medicine 1951718519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1701 N George Mason Dr
Arlington, VA 22205-3610
Phone (703) 558-5000

8118 Good Luck Rd
Lanham, MD 20706-3574
Phone (330) 493-4443

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.6 of 100Reported as group
Quality
76.36
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101279846VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates P.a., P.C. CurrentSince Apr 1, 2024 Accepting new patients
Emergency Medicine Associates P.a., P.C. Internal Medicine CurrentSince Apr 1, 2024 Accepting new patients
Southeastern Intensivist Services PC Internal Medicine CurrentSince Dec 11, 2023 Accepting new patients
Luminis Health Doctors Community Medical Center, Inc. Past Accepting new patients

Locations

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

1401 Johnston Willis Dr
North Chesterfield, VA 23235
Phone (804) 327-4046

7101 Jahnke Rd
Richmond, VA 23225
Phone (804) 323-1088

Organizations & group practices 4

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": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1528697976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 MEDICAL PKWY STE 350",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013081",
            "telephone_number": "443-951-4286",
            "fax_number": "443-949-7380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 MEDICAL PKWY STE 350",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013081",
            "telephone_number": "443-951-4286",
            "fax_number": "443-949-7380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLOYEDE",
        "first_name": "EBENEZER",
        "middle_name": "O.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-07",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101279846",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0097802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.