Damilola Idowu-Ellsworth, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

76660-20 Issued in WI

Practice address

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522

Phone

(412) 495-5645

Fax

(414) 955-0082

NPI assigned

Apr 21, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Damilola Idowu Other name

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Emergency MedicineAlso: Medical Toxicology

Education

Warren Alpert Medical School of Brown University, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Medical College of Wisconsin IncGroup PAC ID 2668384371, 2,092 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Memorial Hospital Hospital, Menomonee Falls, WI, CCN 520103
• Froedtert Memorial Lutheran Hospital Hospital, Milwaukee, WI, CCN 520177

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: oidowu562296@direct.froedtert.com

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.

• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086

  Emergency Medicine

  Medicare reassignment Care Compare group NPD
• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Internal Medicine Physician
  • Menomonee Falls, WI
  • NPI 1568787448
  Medicare reassignment NPD
• Children'S Specialty Group, Inc.

  • Pediatrics Physician
  • Milwaukee, WI
  • NPI 1942970405
  Medicare reassignment
• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Wauwatosa, WI
  • NPI 1154947224
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Community Memorial Hospital of Menomonee Falls Inc

  • General Acute Care Hospital
  • Menomonee Falls, WI
  • NPI 1609822881
  Care Compare affiliation
• Froedtert Memorial Lutheran Hospital, Inc.

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1255334173
  Care Compare affiliation

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

{
    "created_epoch": "1524268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1679060933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "412-495-5645",
            "fax_number": "414-955-0082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "412-495-5645",
            "fax_number": "414-955-0082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDOWU-ELLSWORTH",
        "first_name": "DAMILOLA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-21",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "76660-20",
            "primary": true
        },
        {
            "code": "207PT0002X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Medical Toxicology",
            "state": "WI",
            "license": "76660-20",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679060933",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAMILOLA",
            "last_name": "IDOWU",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ideal Home Cae, LLC
• Ideal Living Home Care LLC
• Christy Ann Idichandy, MD
• Alicia E Idler-Perez, MD
• Idoc Wisconsin Telehealth Solutions LLC
• Idris Medical Transports LLC
• Ahmad H Idriss, RPH
• Stefan Idso
• Kathleen E Idstein, PA
• Emily Igl, CFY/SLP

• Emergency Medicine Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Emergency Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; 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.