Ifeoluwa Balogun, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

323967 Issued in NY

Practice address

230 W 17TH St
New York, NY 10011-5325

Phone

(212) 206-5200

NPI assigned

Jun 19, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, NY2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Community Health of South Florida Inc

  • Federally Qualified Health Center (FQHC)
  • Miami, FL
  • NPI 1336152347
  Medicare reassignment NPD
• Community Health of South Florida Inc

  • Federally Qualified Health Center (FQHC)
  • Key West, FL
  • NPI 1144890013
  NPD
• Community Health of South Florida, Inc

  • Federally Qualified Health Center (FQHC)
  • Key Largo, FL
  • NPI 1417704198
  NPD

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

{
    "created_epoch": "1560902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1548820806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 W 17TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100115325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 W 17TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100115325",
            "telephone_number": "212-206-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALOGUN",
        "first_name": "IFEOLUWA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-19",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "167320",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME161809",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "323967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jillian Balog, PTA
• Justine Balog, MOT, OTR/L
• Noemi Csilla Balogh, MD
• Dolapo Balogun
• Fiyinfolu Oladele Balogun, M.D., PH.D.
• Oluwakemi Margaret Balogun, MD
• Onyinye Balogun, M.D.
• Risikat Balogun
• Michael Scott Balot
• Stamatela Balou, PHD, CCC-SLP, BCS-S

• Family Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.