Samuel Akintola Gbenro, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01063139A Issued in IN

Practice address

9800 Valparaiso Dr
Munster, IN 46321-4040

Phone

(219) 934-9800

Fax

(219) 924-8831

NPI assigned

Feb 20, 2007

Last updated

Jul 31, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Family Practice

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Franciscan Health Munster Hospital, Munster, IN, CCN 150165
• Franciscan Health Dyer Hospital, Dyer, IN, CCN 150090
• Community Hospital Hospital, Munster, IN, CCN 150125

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sgbenro64260@direct.franciscanalliance.org

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.

• Franciscan Physician Network

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1225327984
  Medicare reassignment Care Compare group NPD
• Franciscan Physician Network

  • Clinic/Center
  • Lafayette, IN
  • NPI 1992543250
  NPD
• Childrens & Family Medicine Clinic PC

  • Primary Care Clinic/Center
  • Munster, IN
  • NPI 1265978043

  Family Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Franciscan Health Dyer & Hammond

  dba Franciscan Health Dyer

  • General Acute Care Hospital
  • Dyer, IN
  • NPI 1811077431
  Care Compare affiliation
• Franciscan Health Munster

  • General Acute Care Hospital
  • Munster, IN
  • NPI 1427493246
  Care Compare affiliation
• Munster Medical Research Foundation Inc

  dba Community Hospital

  • General Acute Care Hospital
  • Munster, IN
  • NPI 1003918210
  Care Compare affiliation

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1982749008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9800 VALPARAISO DR",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463214040",
            "telephone_number": "219-934-9800",
            "fax_number": "219-924-8831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GBENRO",
        "first_name": "SAMUEL",
        "middle_name": "AKINTOLA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01063139A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200870790",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sgbenro64260@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9800 Valparaiso Dr",
            "city": "Munster",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463214040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ashlyn Garzella
• Edyta Gasiorowska, P.T.
• Tammy Jo Gaska, FNP-C
• Linda S Gatto, NURSE PRACTITIONER
• Debra Jensen Gbabiri, FNP
• Jolene S. Gelarden, RN, MS, FNP
• Jack Gelman, M.D.
• Brian Alfred Genovesi, M.D.
• Matina J Georgeon, CRNA
• Nabeel Ghani, DO

• Family Medicine Physician in Munster, IN
• Providers in Munster, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.