Kingsley Otsioren Abode-Iyamah, M.D.
Individual provider Active NPI Neurological Surgery Physician · Jacksonville, FL
NPI 1578859484 · NPPES record last updated Sep 1, 2020
Key facts
- NPI
- 1578859484
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Neurological Surgery Physician 207T00000X
- License
- ME135498 (FL)
- Practice address
- 4500 San Pablo Rd S
Jacksonville, FL 32224 - Phone
- (904) 953-2000
- NPI assigned
- Jun 20, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Neurosurgery
- Education
- University of Iowa, RJ & L Carver College of Medicine, 2011
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
- Ability Health Services, Inc
Ability Health Services and Rehabilitation LP
Physiotherapy Associates Inc
Mayo Clinic Jacksonville
Lake Area Physical Therapy Inc.
Practice addresses (Care Compare)
1200 Lexington Green LN
Sanford, FL 32771-1013
40 Greenway CT
Newnan, GA 30265-2326
Phone (770) 502-0195
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000
PO Box
Melrose, FL 32666-1099
Hospital & facility affiliations
- Brooks Rehabilitation Home Health
- Mayo Clinic
- Southeast Georgia Health System- Brunswick Campus
- Brooks Rehabilitation Hospital University Campus
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.24 of 100
- Quality
- 74.85
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 72.62
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Spinal fusion | 354 |
| Laminectomy or laminotomy (partial removal of spine bones) | 74 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180615002192 | FL | Practitioner - Neurosurgery | 1557501798 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R9287 | IA | MD | Neurological Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mayo Clinic Jacksonville | Current |
Accepting new patients | |
| Mayo Clinic Jacksonville | Current |
Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Locations
4500 San Pablo Rd S
Jacksonville, FL 32224
Phone (904) 721-4815
Interoperability endpoints
- kabodeiyamah600937@ehrdirect.mayoclinicmsg.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | R9287 | IA | |
| Neurological Surgery Physician | 207T00000X | ME135498 | FL | Yes |
Addresses
Primary practice location
4500 San Pablo Rd S
Jacksonville, FL 32224
Mailing address
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000
Other practice location 1
89 W Copeland Dr
Orlando, FL 32806
Phone (321) 841-7550
Other practice location 2
89 W Copeland Dr
Orlando, FL 32806
Phone (321) 841-7550
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kabodeiyamah600937@ehrdirect.mayoclinicmsg.org |
Other providers in Jacksonville, FL
- Maria Carmela Ablao
- Able Access Home Health LLC
- Ablecare Nemt LLC
- Jasmine Abner
- Laura A Abney
- Delaney Abood
- Laura A Abood
- Mark P Abood
- Theresa B Abood
- John Abram Abordo
All providers in Jacksonville, FL · Neurological Surgery Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 1, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.