Individual provider Active NPI

Sotonye Imadojemu, M.D., M.B.E.

  • Dermatology Physician
  • Boston, MA
National Provider Identifier
1902165012
Registry record updated Jun 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
269982 Issued in MA
Practice address
221 Longwood Ave
Boston, MA 02115-5804
Phone
(617) 525-7975
NPI assigned
May 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2017

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 MT201159 PA
Dermatology Physician 207N00000X 269982 MA Primary

Addresses

Primary practice location

221 Longwood Ave
Boston, MA 02115-5804

Mailing address

41 Avenue Louis Pasteur, 2ND Floor
Suite 216
Boston, MA 02115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20170717000873 MA Practitioner - Dermatology 6608172879 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Perelman School of Med at the University of Pennsylvania, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brigham and Womens Physicians Organization IncGroup PAC ID 3870405988, 2,931 clinicians

Practice addresses (Care Compare)

221 Longwood Ave
Boston, MA 02115-5804
Phone (617) 732-5500

Hospital & facility affiliations

  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110
  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions110
Skin biopsy22

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Physicians Organization Inc Dermatology CurrentSince Jul 1, 2017 Accepting new patients
Brigham and Women'S Hospital Current Accepting new patients
Brigham and Womens Physicians Organization Inc Past Accepting new patients

Locations

221 Longwood Ave
Boston, MA 02115
Phone (617) 732-4918

75 Francis St
Boston, MA 02115

375 Boylston St
Brookline, MA 02445
Phone (508) 718-4010

1153 Centre St
Jamaica Plain, MA 02130
Phone (617) 983-7000

Interoperability endpoints

  • Direct secure messaging: imadojemu.sotonye.bwh@direct.partners.masshiway.net

Organizations & group practices 3

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 & 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": "1336521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498780800000",
    "number": "1902165012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 AVENUE LOUIS PASTEUR, 2ND FLOOR",
            "address_2": "SUITE 216",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155804",
            "telephone_number": "617-525-7975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMADOJEMU",
        "first_name": "SOTONYE",
        "name_prefix": "Dr.",
        "credential": "M.D., M.B.E.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-09",
        "last_updated": "2017-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT201159",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "269982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.