Active NPI
Mutiat T Onigbanjo, M.D.
- Pediatrics Physician
- Baltimore, MD
National Provider Identifier
1972746279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 260462
- Practice address
- 827 Linden Ave
Baltimore, MD 21201-4606 - Phone
- (410) 225-8780
- Fax
- (410) 225-8766
- NPI assigned
- Apr 16, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 260462 | NY | Primary |
Addresses
Primary practice location
827 Linden Ave
Baltimore, MD 21201-4606
Mailing address
PO Box 62063
Baltimore, MD 21264-2063
Phone (410) 706-5181
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 260462 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 260462 | NY | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Maryland Pediatric Associates, PA | Pediatrics | Current | Accepting new patients |
| University of Maryland Pediatric Associates, PA | Pediatrics | Current | Accepting new patients |
| University of Maryland Pediatrics Assoc PA | Current | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Locations
827 Linden Ave
Fl 1
Baltimore, MD 21201
Phone (410) 225-8780
300 Armory Pl
Baltimore, MD 21201
Phone (410) 225-8215
827 Linden Ave
Baltimore, MD 21201
Phone (410) 225-8100
12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255
Interoperability endpoints
- monigbanjo472171@direct.umm.edu
Organizations & group practices 4
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.
-
- Pediatrics Physician
- Baltimore, MD
- NPI 1528163912
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Baltimore, MD
- NPI 1083933444
Pediatrics
-
- Clinical Medical Laboratory
- Baltimore, MD
- NPI 1003911413
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471910400000",
"number": "1972746279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 62063",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212642063",
"telephone_number": "410-706-5181",
"fax_number": "410-706-5103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "827 LINDEN AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212014606",
"telephone_number": "410-225-8780",
"fax_number": "410-225-8766"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ONIGBANJO",
"first_name": "MUTIAT",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-16",
"last_updated": "2016-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "260462",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "260462",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.