Individual provider Active NPI

Moriam O Ayo Amu, M.D.

  • Family Medicine Physician
  • Riverview, FL
National Provider Identifier
1891085189
Registry record updated Apr 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME114970 Issued in FL
Practice address
10141 Big Bend Rd.
Suite 101
Riverview, FL 33578-7419
Phone
(813) 397-1270
Fax
(813) 397-1271
NPI assigned
Apr 8, 2011
Last updated
Apr 3, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME114970 FL Primary

Addresses

Primary practice location

10141 Big Bend Rd.
Suite 101
Riverview, FL 33578-7419

Mailing address

PO Box 10744
Clearwater, FL 33757-8744
Phone (727) 532-0002

Other identifiers 1

IdentifierTypeStateIssuer
009249400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20130806000811 FL Practitioner - Family Practice 9436391307 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

2461 Enterprise Rd
Suite C
Clearwater, FL 33763-1726
Phone (727) 725-5060

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME114970FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. Family Medicine CurrentSince May 1, 2015 Accepting new patients
Baycare Medical Group, Inc. Family Medicine CurrentSince May 1, 2015 Accepting new patients

Locations

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

10141 Big Bend Rd
Ste 101
Riverview, FL 33578
Phone (813) 397-1270

Interoperability endpoints

  • Direct secure messaging: moriam.ayo-amu.1@26845.direct.athenahealth.com
  • Direct secure messaging: moriamo.ayo-amu@direct.mybaycare.org

Organizations & group practices 2

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 4

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": "1302220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522713600000",
    "number": "1891085189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10744",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337578744",
            "telephone_number": "727-532-0002",
            "fax_number": "727-266-4943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10141 BIG BEND RD.",
            "address_2": "SUITE 101",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335787419",
            "telephone_number": "813-397-1270",
            "fax_number": "813-397-1271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYO AMU",
        "first_name": "MORIAM",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-08",
        "last_updated": "2018-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME114970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009249400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverview, FL

Sources for this page

Verify at the official NPI Registry.