Individual provider Active NPI

Fiyinfoluwa Fawibe, MD

  • Family Medicine Physician
  • San Bernardino, CA
National Provider Identifier
1932586344
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A145359 Issued in CA
Practice address
1455 E 3Rd St.
San Bernardino, CA 92410
Phone
(909) 382-7100
NPI assigned
May 5, 2015
Last updated
Jan 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A145359 CA Primary
Public Health & General Preventive Medicine Physician 2083P0901X A145359 CA

Addresses

Primary practice location

1455 E 3Rd St.
San Bernardino, CA 92410

Mailing address

1455 E 3Rd St.
San Bernardino, CA 92410
Phone (909) 382-7100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20191009003149 CA Practitioner - Family Practice 4587995337 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Georgia School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bakersfield Family Medical Group IncGroup PAC ID 9335052737, 20 clinicians

Practice addresses (Care Compare)

4580 California Ave
Bakersfield, CA 93309-1104
Phone (661) 327-4411

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A145359CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bakersfield Family Medical Group Inc Family Medicine CurrentSince Aug 28, 2023 Accepting new patients
Dap Health, Inc. Family Medicine Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Family Medicine CurrentSince Feb 16, 2022 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Feb 16, 2022 Accepting new patients
Coastal Communities Physician Network, Inc. Past Accepting new patients

Locations

4580 California Ave
Bakersfield, CA 93309
Phone (661) 327-4411

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

82934 Civic Center Dr
Indio, CA 92201
Phone (760) 477-0733

11234 Anderson St
#A600
Loma Linda, CA 92350
Phone (909) 558-2824

25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: fiyinfoluwa.fawibe.p1@direct.bfmc.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1430784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1932586344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 E 3RD ST.",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92410",
            "telephone_number": "909-382-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 E 3RD ST.",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92410",
            "telephone_number": "909-382-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAWIBE",
        "first_name": "FIYINFOLUWA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-05",
        "last_updated": "2022-01-04",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A145359",
            "primary": true
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "CA",
            "license": "A145359",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.