Oyedolapo Adeaga, M.D
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · New York, NY
NPI 1013324490 · NPPES record last updated Feb 2, 2016
Key facts
- NPI
- 1013324490
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 1901 1St Ave
New York, NY 10029-7404 - Phone
- (212) 423-6262
- NPI assigned
- Jul 17, 2014
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NJ, NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150916003280 | NJ | Practitioner - Psychiatry | 5294042644 | Reassigns benefits to 1 organization |
| I20160819000399 | NY | Practitioner - Psychiatry | 5294042644 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 284214 | NY | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Metropolitan Medical Practice Plan PC | Current |
Accepting new patients |
Locations
1901 1st Ave
New York, NY 10029
Phone (212) 230-6262
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
1901 1St Ave
New York, NY 10029-7404
Mailing address
1901 1St Ave
New York, NY 10029-7404
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 372026D 00679 | Other | GHI |
Other providers in New York, NY
- Nicole Addonizio
- Doreen Addrizzo-Harris
- Jermyn Addy
- Marianine Ade
- Samantha Ade
- Davis Adeyemi Adebanjo
- Adegboyega Temitope Adebayo
- Olukayode Adebisi
- Oluwatobi Olufunto Adeboyejo
- Kayla A Adecer
All providers in New York, NY · Student in an Organized Health Care Education/Training Program in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 2, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.