Abimbolu S. Makinde, M.D.

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

MD60465979 Issued in WA

Practice address

19110 Bothell Way NE Ste 102
Bothell, WA 98011-2970

Phone

(425) 286-8271

Fax

(425) 286-8271

NPI assigned

Jul 1, 2011

Sex

Male

Sole proprietor

Yes

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 WA2 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

Specialty

Sports MedicineAlso: Family Practice

Education

University of Arizona College of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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.

• Maksportsmd

  • Sports Medicine (Family Medicine) Physician
  • Bothell, WA
  • NPI 1417469404
  Medicare reassignment NPD Authorized official
• Therapy Management Services, PLLC

  • Durable Medical Equipment & Medical Supplies
  • Bothell, WA
  • NPI 1811252729
  NPD (past)

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

{
    "created_epoch": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1669769337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19110 BOTHELL WAY NE STE 102",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980112970",
            "telephone_number": "425-286-8271",
            "fax_number": "425-491-7271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19110 BOTHELL WAY NE STE 102",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980112970",
            "telephone_number": "425-286-8271",
            "fax_number": "425-286-8271"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1629 220th St SE",
            "address_2": "Suite 201",
            "address_purpose": "LOCATION",
            "city": "Bothell",
            "state": "WA",
            "postal_code": "980218466",
            "country_code": "US",
            "telephone_number": "425-486-1000",
            "fax_number": "425-939-5220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAKINDE",
        "first_name": "ABIMBOLU",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-01",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60465979",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "AZ",
            "license": "47434",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "WA",
            "license": "MD60465979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Maher
• Lauren Donahue Mahr, DPT
• Mike Mai
• Isabel Wanjiku Maina
• Claire Makepeace
• Maksportsmd
• Theresa Malamel
• Lucy Rae Mallory, CBT
• Ashtin Mancinelli, LMHC
• Manjote Dhaliwal DDS PLLC

• Sports Medicine (Family Medicine) Physician in Bothell, WA
• Providers in Bothell, WA by specialty
• Sports Medicine (Family Medicine) Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.