Individual provider Active NPI

Adedeji Olatunji Karunwi, M.D

  • Internal Medicine Physician
  • Royal Oak, MI
National Provider Identifier
1619143849
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301087402 Issued in MI
Practice address
4840 Woodland Ave
Apt 107
Royal Oak, MI 48073-1446
Phone
(248) 556-6369
NPI assigned
May 7, 2008
Last updated
Sep 16, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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 D68782 MD
Internal Medicine Physician 207R00000X 4301087402 MI Primary

Addresses

Primary practice location

4840 Woodland Ave
Apt 107
Royal Oak, MI 48073-1446

Mailing address

4840 Woodland Ave
Apt 107
Royal Oak, MI 48073-1446
Phone (248) 556-6369

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 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
I20090817000402 DC Practitioner - Internal Medicine 0345394938 Reassigns benefits to 3 organizations
I20111013000237 MD Practitioner - Internal MedicinePractitioner - Hospitalist 0345394938 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1221 Mercantile LN
Largo, MD 20774-5374
Phone (301) 618-5700

655 Watkins Mill Rd
Gaithersburg, MD 20879-3301
Phone (240) 632-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301087402MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates P.a., P.C. CurrentSince Feb 20, 2019 Accepting new patients
Mdics at Meritus Medical Center, LLC CurrentSince Oct 1, 2014 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 19, 2022 Accepting new patients
Emergency Medicine Associates P.a., P.C. Internal Medicine CurrentSince Feb 20, 2019 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Internal Medicine Current Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 19, 2022 Accepting new patients
Luminis Health Doctors Community Medical Center, Inc. Past Accepting new patients

Locations

5255 Loughboro Rd NW
Washington, DC 20016
Phone (202) 243-2280

20010 Century Blvd
Ste 200
Germantown, MD 20874

11116 Medical Campus Rd
Hagerstown, MD 21742
Phone (301) 766-7600

5 Garrett Ave
La Plata, MD 20646
Phone (301) 609-4000

701 Charles St
La Plata, MD 20646
Phone (301) 609-4000

2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

200 Memorial Ave
Westminster, MD 21157
Phone (410) 848-3000

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

100 Fairview Dr
Franklin, VA 23851
Phone (757) 516-1153

Organizations & group practices 8

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": "1210118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1619143849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4840 WOODLAND AVE",
            "address_2": "APT 107",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480731446",
            "telephone_number": "248-556-6369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4840 WOODLAND AVE",
            "address_2": "APT 107",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480731446",
            "telephone_number": "248-556-6369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARUNWI",
        "first_name": "ADEDEJI",
        "middle_name": "OLATUNJI",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-07",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D68782",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301087402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4840 Woodland Ave",
            "address_2": "APT 107",
            "city": "Royal Oak",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480731446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.