NPIMap

Individual provider Active NPI

Ikechukwu D Mbonu, MD

  • Internal Medicine Physician
  • Laurel, MD
National Provider Identifier
1841291788
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0059649 Issued in MD
Practice address
7350 Van Dusen Rd Ste 130
Laurel, MD 20707-5267
Phone
(240) 294-6677
Fax
(240) 294-7645
NPI assigned
Aug 2, 2005
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD035226 DC
Internal Medicine Physician 207R00000X D0059649 MD Primary

Addresses

Primary practice location

7350 Van Dusen Rd Ste 130
Laurel, MD 20707-5267

Mailing address

7350 Van Dusen Rd Ste 130
Laurel, MD 20707-5267
Phone (240) 294-6677

Other identifiers 1

IdentifierTypeStateIssuer
402755800MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050415000695 DC Practitioner - Internal Medicine 7416994819 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adfinitas Health at Umcap LLCGroup PAC ID 0840677738, 53 clinicians

Practice addresses (Care Compare)

901 Harry S Truman Dr
Largo, MD 20774-5477
Phone (240) 677-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0059649MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates P.a., P.C. CurrentSince Feb 1, 2018 Accepting new patients
Adfinitas Health at Umcap, LLC CurrentSince Jul 15, 2022 Accepting new patients
Hospitalist Medicine Physicians of Maryland PC Internal Medicine CurrentSince Apr 23, 2012 Accepting new patients
Emergency Medicine Associates P.a., P.C. Internal Medicine CurrentSince Feb 1, 2018 Accepting new patients
Hospitalist Medicine Physicians of Maryland PC Internal Medicine CurrentSince Apr 23, 2012 Accepting new patients
Metropolitan Medical Specialists LLC Internal Medicine Past Accepting new patients
Medpro Hospitalists LLP Internal Medicine Past Accepting new patients
Hospitalist Medicine Physicians of Front Royal, LLC Internal Medicine Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Matrix House Physicians PA Internal Medicine Past Accepting new patients

Locations

3001 Hospital Dr
Hyattsville, MD 20785
Phone (301) 618-2000

8118 Good Luck Rd
Lanham Seabrook, MD 20706
Phone (301) 552-8608

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

901 Harry S Truman Dr N
Uppr Marlboro, MD 20774
Phone (240) 677-0021

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

100 Fairview Dr
Franklin, VA 23851
Phone (757) 516-1153

Interoperability endpoints

  • Direct secure messaging: imbonu971015@direct.umm.edu

Organizations & group practices 10

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1841291788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7350 VAN DUSEN RD STE 130",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075267",
            "telephone_number": "240-294-6677",
            "fax_number": "240-294-7645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7350 VAN DUSEN RD STE 130",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075267",
            "telephone_number": "240-294-6677",
            "fax_number": "240-294-7645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBONU",
        "first_name": "IKECHUKWU",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DC",
            "license": "MD035226",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0059649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "402755800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

Verify at the official NPI Registry.