Benedict Gbolabo Famori, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

C1-0012550 Issued in DE

Practice address

106 Blanca Ave
Alamosa, CO 81101-2340

Phone

(719) 589-2511

Fax

(719) 587-1372

NPI assigned

Oct 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Dr. Benedict Gbolabo Famoritade Former name

Medicare fee-for-service enrollment

Enrolled in TX, TN2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bfamori358453@directhoustonmethodist.org

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.

• Hospital Medicine Services of TX, PLLC

  • Hospitalist Physician
  • San Antonio, TX
  • NPI 1881392363
  Medicare reassignment NPD
• Saint Thomas Medical Partners

  • Internal Medicine Physician
  • Nashville, TN
  • NPI 1437194669
  Medicare reassignment NPD
• Lutheran Hospital Association of the San Luis Valley

  • General Acute Care Hospital
  • Alamosa, CO
  • NPI 1235181744
  NPD (past)

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

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529020800000",
    "number": "1831386036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 BLANCA AVE",
            "city": "ALAMOSA",
            "state": "CO",
            "postal_code": "811012340",
            "telephone_number": "719-589-2511",
            "fax_number": "719-587-1372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 BLANCA AVE",
            "city": "ALAMOSA",
            "state": "CO",
            "postal_code": "811012340",
            "telephone_number": "719-589-2511",
            "fax_number": "719-587-1372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAMORI",
        "first_name": "BENEDICT",
        "middle_name": "GBOLABO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-02",
        "last_updated": "2018-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CO",
            "license": "46889",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "LA",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C1-0012550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18807313",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1076830",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BENEDICT",
            "last_name": "FAMORITADE",
            "middle_name": "GBOLABO",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sally A Espinoza, MA
• Richard Esquibel, CAC III
• Jose Luis Estrada, DMD
• Jazmin Daryn Evans
• Eye Associates of Colorado Springs, PC
• Ruby Favela
• Bruce E Feldmann
• Kacie Leanna Fisher, NP
• Shannon Michelle Flynn, ATC, LAT
• Mary Fox

• Internal Medicine Physician in Alamosa, CO
• Providers in Alamosa, CO by specialty
• Internal Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.