Abimbola Datonye Iketubosin, FNP in San Manuel, AZ

Abimbola Datonye Iketubosin, FNP is a medicare enrolled "Nurse Practitioner - Family" in San Manuel, Arizona. She graduated from nursing school in 2020 and has 6 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Clinica Sierra Vista and her current practice location is 23 S Mcnab Pkwy, San Manuel, Arizona. You can reach out to her office (for appointments etc.) via phone at (520) 385-2234.

Abimbola Datonye Iketubosin is licensed to practice in Arizona (license number 221449) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1356841514.

Contact Information

	Abimbola Datonye Iketubosin, FNP
	23 S Mcnab Pkwy, San Manuel, AZ 85631-1156
	(520) 385-2234
	(520) 381-3209

Map and Direction

Provider's Profile

Full Name	Abimbola Datonye Iketubosin
Gender	Female
Speciality	Nurse Practitioner
Experience	6 Years
Location	23 S Mcnab Pkwy, San Manuel, Arizona
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Abimbola Datonye Iketubosin graduated from nursing school in 2020

NPI Data:

NPI Number: 1356841514
Provider Enumeration Date: 02/14/2018
Last Update Date: 09/25/2025

Medicare PECOS Information:

PECOS PAC ID: 6709129554
Enrollment ID: I20201029001535

Medical Identifiers

Medical identifiers for Abimbola Datonye Iketubosin such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1356841514	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163WG0000X	Registered Nurse - General Practice	221449 (Arizona)	Secondary
363LF0000X	Nurse Practitioner - Family	221449 (Arizona)	Primary
363LF0000X	Nurse Practitioner - Family	F08180855 (Arizona)	Secondary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Clinica Sierra Vista	3870407505	157

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Abimbola Datonye Iketubosin allows following entities to bill medicare on her behalf.

Entity Name	Gila River Health Care Corporation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1376538231 PECOS PAC ID: 0648174185 Enrollment ID: O20031125000648

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Abimbola Datonye Iketubosin is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Abimbola Datonye Iketubosin, FNP 3815 E Bell Rd, Phoenix, AZ 85032-2122 Ph: () -	Abimbola Datonye Iketubosin, FNP 23 S Mcnab Pkwy, San Manuel, AZ 85631-1156 Ph: (520) 385-2234

Reviews and Comments

Nurse Practitioner Nurses in San Manuel, AZ

Mrs. Naomi Arlene Duffett, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 23 S Mcnab Pkwy, San Manuel, AZ 85631 Phone: 520-385-2234 Fax: 520-381-3209
Mclynda Batterman, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 23 S Mcnab Pkwy, San Manuel, AZ 85631 Phone: 520-385-2234 Fax: 520-381-3209
Mrs. Jacy Kathleen Godsey, APRN-CNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 23 S Mcnab Pkwy, San Manuel, AZ 85631 Phone: 520-385-2234 Fax: 520-381-3209
Sharan Wieberdink, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 23 S Mcnab Pkwy, San Manuel, AZ 85631 Phone: 520-385-2234
Cynthia Dawn Diaz, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 23 S Mcnab Pkwy, San Manuel, AZ 85631 Phone: 520-385-2234 Fax: 520-381-3209

Abimbola Datonye Iketubosin, FNP - Medicare Nurse Practitioner in San Manuel, AZ