Christopher Alade Ibikunle, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

066703 Issued in GA

Practice address

367 Athens Hwy
Building 100 Suite 100a
Loganville, GA 30052-2204

Phone

(678) 466-6760

Fax

(678) 802-7094

NPI assigned

Jan 16, 2008

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 names 1

• Dr. Alade Olorunshola Ibikunle Other name

Medicare fee-for-service enrollment

Enrolled in GA

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

General Surgery

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Georgia SurgicareGroup PAC ID 8325217714, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14247/brand/1/csg/1/fhir/r4
• Direct secure messaging: christopher.ibikunle.1@14247.direct.athenahealth.com

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.

• Georgia Surgicare

  • Multi-Specialty Clinic/Center
  • Loganville, GA
  • NPI 1508150509
  Medicare reassignment Care Compare group NPD Authorized official
• Surgicare Gwinnett

  • Ambulatory Surgical Clinic/Center
  • Loganville, GA
  • NPI 1164833398
  NPD Authorized official
• Surgicare Plus LLC

  • Anesthesiology Physician
  • Loganville, GA
  • NPI 1235541608
  NPD Authorized official
• American House Call Doctors, LLC

  • Family Medicine Physician
  • Richmond Heights, OH
  • NPI 1477710267
  NPD (past) Authorized official
• Meridia Medical Group, LLC

  • Specialist
  • Warrensville Heights, OH
  • NPI 1316992944
  NPD (past)

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

{
    "created_epoch": "1200441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394755200000",
    "number": "1992981302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 ATHENS HWY",
            "address_2": "BUILDING 100 SUITE 100A",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300522204",
            "telephone_number": "678-466-6760",
            "fax_number": "678-802-7094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "367 ATHENS HWY",
            "address_2": "BUILDING 100 SUITE 100A",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300522204",
            "telephone_number": "678-466-6760",
            "fax_number": "678-802-7094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBIKUNLE",
        "first_name": "CHRISTOPHER",
        "middle_name": "ALADE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-16",
        "last_updated": "2014-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "066703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALADE",
            "last_name": "IBIKUNLE",
            "middle_name": "OLORUNSHOLA",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Surgery Physician in Loganville, GA
• Providers in Loganville, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2014; 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.