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DR. MODINAT BALOGUN D.O.
NPI 1710290572
Emergency Medicine in Miami, FL

Active since July 22, 2010PECOS EnrolledAccepts Medicare Assignment
2020 N BAYSHORE DR APT 2205, MIAMI, FL 33137(917) 613-5301 Get Directions Write a Review

NPPES record last updated: March 15, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 28, 2018, Nov 29, 2018 (2 updates tracked since 2018).

About Dr. Modinat Balogun D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MODINAT BALOGUN D.O. (NPI 1710290572) is an individual emergency medicine provider in Miami, Florida, licensed in Florida (OS11999) and active in the NPI registry since July 2010. She is enrolled in Medicare PECOS, is affiliated with Cjw Medical Center, and is a graduate of Other (2007).

NPPES Registry Identity

NPI1710290572
Entity TypeIndividualFemale
Primary Taxonomy207P00000X
Provider Legal NameDR. MODINAT BALOGUNCredential: D.O.
Location Address2020 N BAYSHORE DR APT 2205Miami, FL 33137
Mailing Address2020 N Bayshore Dr Apt 2205Miami, FL 33137-5168 · (917) 613-5301
Phone(917) 613-5301
Sole ProprietorNo
Medical School CMSOtherGraduated 2007
Enumeration DateJuly 22, 2010
Last NPPES UpdateMarch 15, 20222 updates tracked since enumeration
NPPES CertifiedMarch 15, 2022
✔ NPI 1710290572 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
Licenses✔ Licensed in FL · OS11999✔ Licensed in NY · 260255
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
2020 N BAYSHORE DR APT 2205, Miami, FL 33137
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare, Cigna HealthCare of Florida, Inc., Oscar Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Modinat Balogun D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID42484644
PECOS Enrollment IDI20250106002167
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

6

Medicare enrollment records show Modinat Balogun reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Duval Emergency Group LLC
9.3 mi
Emergency Medicine
160 NW 170TH ST
North Miami Beach, FL 33169
  • Reassigned Medicare billing, Florida enrollment
  • 81 clinicians in this Medicare group
NPI 1053645465 (305) 651-1100
Paragon Emergency Services LLC
181 mi
Emergency Medicine
200 AVENUE F NE
Winter Haven, FL 33881
  • Reassigned Medicare billing, Florida enrollment
  • 1,065 clinicians in this Medicare group
NPI 1912101650 (863) 293-1121
W4p LLC
233 mi
Emergency Medicine
10461 QUALITY DR
Spring Hill, FL 34609
  • Reassigned Medicare billing, Florida enrollment
  • 118 clinicians in this Medicare group
NPI 1689116618 (352) 688-8200
Paragon Contracting Services LLC
663 mi
Emergency Medicine
810 SAINT VINCENTS DR
Birmingham, AL 35205
  • Reassigned Medicare billing, Florida enrollment
  • 802 clinicians in this Medicare group
NPI 1225071459 (205) 939-7100
Emergency Coverage, LLC
723 mi
Family Medicine
435 2ND ST
Newport, TN 37821
  • Reassigned Medicare billing, Virginia enrollment
  • 679 clinicians in this Medicare group
NPI 1427005008 (423) 625-2200
Island Emergency Medical Services, P.C.
1,085 mi
Emergency Medicine
327 BEACH 19TH ST
Far Rockaway, NY 11691
  • Reassigned Medicare billing, New York enrollment
  • Medicare enrollment name: Island Emergency Medical Services PC
  • 290 clinicians in this Medicare group
NPI 1639160385 (844) 474-4019

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
106 services100 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
32 services32 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
19 services19 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Cjw Medical Center

Acute Care Hospitals · Richmond, VA
4/5 CMS rating
OwnershipProprietary
CMS Certification Number490112
Location7101 Jahnke RoadRichmond, VA 23235 · Chesterfield County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33137 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.13 typical visit price
range $60.92 – $187.05
Typical copayment $24.03 (range $15.23 – $46.76)
Most-billed visit code 99203
Established Patient
$107.17 typical visit price
range $18.99 – $150.24
Typical copayment $26.79 (range $4.74 – $37.56)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Modinat Balogun's NPI number?

The NPI number for Modinat Balogun is 1710290572. It was assigned to this individual provider in the NPPES registry on July 22, 2010.

Where is Modinat Balogun located?

Modinat Balogun practices at 2020 N Bayshore Dr Apt 2205, Miami, FL 33137. The listed phone number is (917) 613-5301.

What is Modinat Balogun's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Modinat Balogun enrolled in Medicare?

Yes. Modinat Balogun is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Modinat Balogun's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Modinat Balogun reassigns Medicare benefits to 6 organizations: Duval Emergency Group LLC (North Miami Beach, FL), Paragon Emergency Services LLC (Winter Haven, FL), W4p LLC (Spring Hill, FL), Paragon Contracting Services LLC (Birmingham, AL), Emergency Coverage, LLC (Newport, TN) and 1 more organization, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Modinat Balogun's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Modinat Balogun accept?

Health plans from Cigna HealthCare of Florida, Inc., Cigna Healthcare, Oscar Health, Oscar Health Maintenance Organization of Florida and Oscar Insurance Company list Modinat Balogun as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Modinat Balogun affiliated with any hospitals?

According to CMS data, Modinat Balogun is affiliated with Cjw Medical Center.

When was this NPI record last updated?

The NPPES record for Modinat Balogun was last updated on March 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.