Modupe A. Aiyegbusi, M.D.

Key facts

NPI

1710088349

Entity type

Individual (NPI type 1)

Primary specialty

Family Medicine Physician 207Q00000X

License

A65390 (CA)

Practice address

21350 Hawthorne Blvd
Suite 157
Torrance, CA 90503-5605

Phone

(310) 540-7240

Fax

(310) 540-7280

NPI assigned

Sep 26, 2006

Sex

Female

Sole proprietor

No

Organizations & group practices 12

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.

• Prohealth Partners, a Medical Group Internal Medicine Physician · Lakewood, CA · NPI 1003949975
  Medicare reassignment Care Compare group NPD CA
• Prohealth Partners a Medical Group Orthopaedic Surgery Physician · Long Beach, CA · NPI 1265982359
  Care Compare group
• Prohealth Partners a Medical Group Orthopaedic Surgery Physician · Los Alamitos, CA · NPI 1982154019
  Care Compare group
• Prohealth Partners, a Medical Group Foot & Ankle Surgery Podiatrist · Long Beach, CA · NPI 1437282316
  Care Compare group
• Prohealth Partners a Medical Group Cardiovascular Disease Physician · Torrance, CA · NPI 1427480987
  NPD
• Prohealth Partners, a Medical Group, Inc. Internal Medicine Physician · Pico Rivera, CA · NPI 1912899394
  NPD
• Healthcare Partners Affiliates Medical Group Internal Medicine Physician · Los Angeles, CA · NPI 1659312593
  NPD (past) FAMILY MEDICINE
• Prime Healthcare Centinela, LLC General Acute Care Hospital · Inglewood, CA · NPI 1336328244
  NPD (past)
• Providence Health System - Southern California Psychiatric Hospital Unit · San Pedro, CA · NPI 1154349371
  NPD (past)
• Providence Health System Southern California General Acute Care Hospital · Torrance, CA · NPI 1902844988
  NPD (past)
• Torrance Memorial Medical Center Skilled Nursing Facility · Torrance, CA · NPI 1740268713
  NPD (past)
• Frederick Health Hospital Inc General Acute Care Hospital · Frederick, MD · NPI 1538165527
  NPD (past)

Hospital & facility affiliations 2

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

• Providence Health System Southern California General Acute Care Hospital · Torrance, CA · NPI 1902844988
  Care Compare affiliation Hospital
• Torrance Memorial Medical Center General Acute Care Hospital · Torrance, CA · NPI 1467459776
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Family Practice

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prohealth Partners, a Medical Group (236 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Torrance Memorial Medical Center Hospital · Torrance, CA · CCN 050351
• Providence Little Company of Mary Med Ctr Torrance Hospital · Torrance, CA · CCN 050353

Medicare participation

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles (9 of 10)

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 23, 2017.

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490227200000",
    "number": "1710088349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3661 TORRANCE BLVD",
            "address_2": "STE 103",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034887",
            "telephone_number": "310-540-7240",
            "fax_number": "310-540-7280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21350 HAWTHORNE BLVD",
            "address_2": "SUITE 157",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905035605",
            "telephone_number": "310-540-7240",
            "fax_number": "310-540-7280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AIYEGBUSI",
        "first_name": "MODUPE",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2017-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A65390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A653900",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

• Maria Kathleen Aiello, DDS
• Maribel Aila
• Qurat U Ain, BA
• Magdalena Aispuro
• Aiyegbusi and Braimah Medical Corp.
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• Aj&B Home Care Agency LLC
• Amir H Ajar, M.D.
• Remi Musibau Ajiboye, MD
• Aslam Abbasi Akhtar, MD

All providers in Torrance, CA · Family Medicine Physician in California