Individual provider Active NPI

Yetunde Adedunni Sannoh, MD

  • Internal Medicine Physician
  • Upper Marlboro, MD
National Provider Identifier
1871752717
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D75522 Issued in MD
Practice address
9500 Marlboro Pike Ste 12
Upper Marlboro, MD 20772-3766
Phone
(301) 494-1006
Fax
(301) 494-8506
NPI assigned
Jun 5, 2008
Last updated
Jan 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

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 D75522 MD Primary
Internal Medicine Physician 207R00000X 063346 GA

Addresses

Primary practice location

9500 Marlboro Pike Ste 12
Upper Marlboro, MD 20772-3766

Mailing address

9500 Marlboro Pike Ste 12
Upper Marlboro, MD 20772-3766
Phone (202) 870-7275

Other practice location 1

605 Post Office Rd Ste 101
Waldorf, MD 20602-1913
Phone (301) 494-1006

Other identifiers 1

IdentifierTypeStateIssuer
164455019CMedicaidGA

Other names 1

  • Yetunde Adedunni Aderibigbe Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 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

Enrollment IDStateProvider typePAC IDDetails
I20130619000635 DC Practitioner - Internal Medicine 9931247137 Reassigns benefits to 4 organizations
I20131010000869 MD Practitioner - Internal Medicine 9931247137 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Luminis Health Medical Group, LLCGroup PAC ID 2860447315, 540 clinicians

Practice addresses (Care Compare)

2001 Medical Pkwy
Annapolis, MD 21401-3280
Phone (443) 481-1000

9500 Marlboro Pike
Suite 12
Upper Marlboro, MD 20772-3766
Phone (301) 494-1006

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
063346GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mdics at Calvert LLC CurrentSince Jun 2, 2014 Accepting new patients
Total Wellness & Health Center Inc CurrentSince Jan 15, 2022 Accepting new patients
Luminis Health Medical Group, LLC Current Accepting new patients
Medstar Medical Group II LLC CurrentSince Mar 1, 2021 Accepting new patients
Medstar Medical Group II LLC CurrentSince Nov 2, 2017 Accepting new patients
Medstar Medical Group II LLC Internal Medicine CurrentSince Mar 1, 2021 Accepting new patients
Medstar Medical Group II LLC CurrentSince Nov 2, 2017 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Dec 9, 2019 Accepting new patients
Monimils LLC Internal Medicine CurrentSince Dec 8, 2017 Accepting new patients
Total Wellness Clinic LLC Internal Medicine Current Accepting new patients
Luminis Health Medical Group, LLC Internal Medicine CurrentSince Dec 9, 2019 Accepting new patients
MGMC, LLC Current Accepting new patients
Luminis Health Anne Arundel Medical Center, Inc. Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

3800 Reservoir Rd NW
Washington, DC 20007
Phone (202) 687-2203

2001 Medical Pkwy
Annapolis, MD 21401
Phone (410) 280-5601

2003 Medical Pkwy
Ste 301
Annapolis, MD 21401
Phone (443) 481-3366

7503 Surratts Rd
Clinton, MD 20735
Phone (301) 868-8000

100 Hospital Rd
Prnc Frederck, MD 20678
Phone (410) 414-4791

605 Post Office Rd
Ste 101
Waldorf, MD 20602
Phone (301) 494-1006

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16526/brand/1/csg/1/fhir/r4

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 2

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": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1871752717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 MARLBORO PIKE STE 12",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207723766",
            "telephone_number": "202-870-7275",
            "fax_number": "301-494-8506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 MARLBORO PIKE STE 12",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207723766",
            "telephone_number": "301-494-1006",
            "fax_number": "301-494-8506"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "605 Post Office Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Waldorf",
            "state": "MD",
            "postal_code": "206021913",
            "country_code": "US",
            "telephone_number": "301-494-1006",
            "fax_number": "301-494-8506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANNOH",
        "first_name": "YETUNDE",
        "middle_name": "ADEDUNNI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-05",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D75522",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "063346",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164455019C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YETUNDE",
            "last_name": "ADERIBIGBE",
            "middle_name": "ADEDUNNI",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Upper Marlboro, MD

Sources for this page

Verify at the official NPI Registry.