Individual provider Active NPI

Ayoola O Akinbamowo, MD

  • Nephrology Physician
  • Hanover, PA
National Provider Identifier
1992830509
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD433854 Issued in PA
Practice address
1227 Baltimore St
Hanover, PA 17331-4406
Phone
(717) 339-2760
Fax
(717) 630-1120
NPI assigned
Feb 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MD433854 PA Primary

Addresses

Primary practice location

1227 Baltimore St
Hanover, PA 17331-4406

Mailing address

3421 Concord Rd
York, PA 17402-9001
Phone (717) 339-2760

Other practice location 1

3130 Grandview Rd
Hanover, PA 17331-9134
Phone (717) 339-2760

Other identifiers 10

IdentifierTypeStateIssuer
933062OtherMDCAREFIRST MD BCBS
2058519OtherPAHIGHMARK BLUE SHIELD
210883OtherPAJOHNS HOPKINS
243645OtherPAUNISON-WMG
9374251OtherPAAETNA
50078661OtherPACAPITAL BLUE CROSS-WMG
1575953OtherPAGATEWAY-WMG
102151517MedicaidPA
120279OtherPAGEISINGER HEALTH PLAN
20078633OtherPAAMERIHEALTH MERCY-WMG

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20080910000156 PA Practitioner - Nephrology 7012083348 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

1227 Baltimore St
Hanover, PA 17331-4406
Phone (717) 812-7559

147 Gettys St
Gettysburg, PA 17325-2534
Phone (717) 334-2121

25 Monument Rd
York, PA 17403-5073

2618 E Market St
Autumn House
York, PA 17403
Phone (717) 845-7214

914 W Market St
Autumn House West
York, PA 17403
Phone (717) 845-7214

Hospital & facility affiliations

  • DaVita Hanover Dialysis Dialysis facility, Hanover, PA, CCN 392839
  • DaVita Heritage Lake Dialysis Dialysis facility, Gettysburg, PA, CCN 392869
  • Gettysburg Hospital Hospital, Gettysburg, PA, CCN 390065
  • Upmc Hanover Hospital, Hanover, PA, CCN 390233
  • Wellspan York Hospital Hospital, York, PA, CCN 390046

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group Current Accepting new patients
Wellspan Medical Group CurrentSince Sep 8, 2008 Accepting new patients
Wellspan Medical Group CurrentSince Sep 8, 2008 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1227 Baltimore St
Hanover, PA 17331
Phone (717) 646-4204

3130 Grandview Rd
Hanover, PA 17331
Phone (717) 633-1433

43 S Columbus Ave
Ste 101
Littlestown, PA 17340
Phone (717) 339-2760

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

1600 S George St
York, PA 17403
Phone (717) 848-3615

Interoperability endpoints

  • Direct secure messaging: aakinbamowo13875@wellspan.direct-ci.com

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.

Hospital & facility affiliations 10

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": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1992830509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 CONCORD RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174029001",
            "telephone_number": "717-339-2760",
            "fax_number": "717-359-9427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 BALTIMORE ST",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173314406",
            "telephone_number": "717-339-2760",
            "fax_number": "717-630-1120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3130 Grandview Rd",
            "address_purpose": "LOCATION",
            "city": "Hanover",
            "state": "PA",
            "postal_code": "173319134",
            "country_code": "US",
            "telephone_number": "717-339-2760",
            "fax_number": "717-630-1120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AKINBAMOWO",
        "first_name": "AYOOLA",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "MD433854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MD BCBS",
            "identifier": "933062",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "2058519",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHNS HOPKINS",
            "identifier": "210883",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON-WMG",
            "identifier": "243645",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9374251",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS-WMG",
            "identifier": "50078661",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY-WMG",
            "identifier": "1575953",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102151517",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER HEALTH PLAN",
            "identifier": "120279",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY-WMG",
            "identifier": "20078633",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanover, PA

Sources for this page

Verify at the official NPI Registry.