Individual provider Active NPI

Ann Ilufoye, CRNP

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1639904246
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
SP030299 Issued in PA
Practice address
5800 Walnut St
Philadelphia, PA 19139-3836
Phone
(215) 474-4444
Fax
(215) 474-6021
NPI assigned
Sep 4, 2024
Last updated
May 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 26NJ15128500 NJ
Family Medicine Physician 207Q00000X SP030299 PA Primary

Addresses

Primary practice location

5800 Walnut St
Philadelphia, PA 19139-3836

Mailing address

5800 Walnut St
Philadelphia, PA 19139-3836
Phone (215) 474-4444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241001001156 PA Practitioner - Nurse Practitioner 6204367345 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sayre Health CenterGroup PAC ID 7416955000, 6 clinicians

Practice addresses (Care Compare)

5800 Walnut St
Rear
Philadelphia, PA 19139-3836
Phone (215) 474-4444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NJ15128500NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sayre Health Center CurrentSince Sep 26, 2024 Accepting new patients

Locations

5800 Walnut St
Rear
Philadelphia, PA 19139
Phone (215) 474-4444

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73304
  • FHIR API: https://fhir4.healow.com/fhir/r4/CHJCDD

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1725408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1639904246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 WALNUT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191393836",
            "telephone_number": "215-474-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 WALNUT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191393836",
            "telephone_number": "215-474-4444",
            "fax_number": "215-474-6021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILUFOYE",
        "first_name": "ANN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-04",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "26NJ15128500",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "SP030299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.