Individual provider Active NPI

Adeyemisi O Sosanya, MD

  • Internal Medicine Physician
  • Baltimore, MD
National Provider Identifier
1669448767
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0061439 Issued in MD
Practice address
2600 Liberty Heights Ave
Baltimore, MD 21215
Phone
(410) 383-4424
Fax
(410) 383-7918
NPI assigned
Feb 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0061439 MD Primary

Addresses

Primary practice location

2600 Liberty Heights Ave
Baltimore, MD 21215

Mailing address

PO Box 922
Brooklandville, MD 21022
Phone (410) 383-4424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040706001281 MD Practitioner - Internal Medicine 0446237572 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0061439MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Luminis Health Medical Group, LLC Current Accepting new patients
Luminis Health Medical Group, LLC CurrentSince May 1, 2020 Accepting new patients
Luminis Health Medical Group, LLC Internal Medicine CurrentSince May 1, 2020 Accepting new patients
Westside Medical Group L. L. C Internal Medicine Past Accepting new patients
Westside Medical Group Inc Past Accepting new patients

Locations

2001 Medical Pkwy
Annapolis, MD 21401
Phone (410) 280-5601

2003 Medical Pkwy
Ste 301
Annapolis, MD 21401
Phone (443) 481-3366

Organizations & group practices 5

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": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669448767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 922",
            "city": "BROOKLANDVILLE",
            "state": "MD",
            "postal_code": "21022",
            "telephone_number": "410-383-4424",
            "fax_number": "410-383-7918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 LIBERTY HEIGHTS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21215",
            "telephone_number": "410-383-4424",
            "fax_number": "410-383-7918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOSANYA",
        "first_name": "ADEYEMISI",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0061439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.