Individual provider Active NPI

Abolanle Abosede Olubunmi

  • Primary Care Nurse Practitioner
  • Annapolis, MD
National Provider Identifier
1982005708
Registry record updated Sep 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
RN139784 Issued in MD
Practice address
1833 Forest Dr
Annapolis, MD 21401-4580
Phone
(410) 216-9180
NPI assigned
Sep 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN139784 MD
Gerontology Nurse Practitioner 363LG0600X RN139784 MD
Primary Care Nurse Practitioner 363LP2300X RN139784 MD Primary

Addresses

Primary practice location

1833 Forest Dr
Annapolis, MD 21401-4580

Mailing address

3033 N Dale LN
Bowie, MD 20716-1325
Phone (301) 437-2228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141020001220 MD Practitioner - Nurse Practitioner 2264653039 Reassigns benefits to 1 organization
I20170405001603 DC Practitioner - Nurse Practitioner 2264653039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
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)

2191 Defense Hwy
Suite 201
Crofton, MD 21114-2469
Phone (410) 451-9091

4000 Mitchellville Rd
Suite B116
Bowie, MD 20716-3143
Phone (301) 599-9500

4175 N Hanson Court
201 Luminis Health Breast Center of Bowie
Bowie, MD 20716-3181
Phone (443) 481-5300

4175 N Hanson CT
Bowie, MD 20716-3181

8116 Good Luck Rd
Lanham, MD 20706-3508

Merit-based Incentive Payment System (MIPS)

Final score
81.45 of 100Reported as group
Quality
67.28
Promoting interoperability
98
Improvement activities
40
Cost
72.57

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN139784MDMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Luminis Health Medical Group, LLC Current Accepting new patients
Luminis Health Medical Group, LLC Current Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Apr 1, 2020 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Apr 1, 2020 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Jun 2, 2020 Accepting new patients
Capital Orthopaedic Specialists LLC Past Accepting new patients
Luminis Health Medical Group, LLC Past Accepting new patients

Locations

2001 Medical Pkwy
Ofc
Annapolis, MD 21401
Phone (443) 481-1091

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

4000 Mitchellville Rd
Ste B116
Bowie, MD 20716
Phone (301) 464-4503

4175 N Hanson Ct
Ste 201
Bowie, MD 20716
Phone (443) 481-1199

1630 Main St
Ste 213
Chester, MD 21619
Phone (443) 481-5300

2191 Defense Hwy
Ste 201
Crofton, MD 21114
Phone (410) 451-9091

28438 Marlboro Ave
Easton, MD 21601
Phone (410) 820-7270

8116 Good Luck Rd
Ste 200
Lanham, MD 20706
Phone (301) 552-4131

8116 Good Luck Rd
Lanham, MD 20706
Phone (410) 882-3459

8118 Good Luck Rd
Lanham Seabrook, MD 20706
Phone (301) 552-8608

1106 Annapolis Rd
Ste 130
Odenton, MD 21113
Phone (410) 295-8900

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1410393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410393600000",
    "number": "1982005708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 N DALE LN",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207161325",
            "telephone_number": "301-437-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1833 FOREST DR",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214014580",
            "telephone_number": "410-216-9180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLUBUNMI",
        "first_name": "ABOLANLE",
        "middle_name": "ABOSEDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-11",
        "last_updated": "2014-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "RN139784",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MD",
            "license": "RN139784",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MD",
            "license": "RN139784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.