Olusegun M Adeonigbagbe, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

201260 Issued in NY

Practice address

19203 Jamaica Ave
Hollis, NY 11423-2529

Phone

(718) 217-7744

Fax

(718) 217-7233

NPI assigned

Apr 26, 2006

Last updated

Aug 4, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 13

Medicare fee-for-service enrollment

Enrolled in NY

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

Gastroenterology

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Interfaith Professional Physician Services PCGroup PAC ID 9931378171, 383 clinicians

Brownsville Community Development CorporationGroup PAC ID 7416903323, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Brookdale Hospital Medical Center Hospital, Brooklyn, NY, CCN 330233

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DGJDAA/Endpoint/DGJDAA
• Direct secure messaging: olusegun.adeonigbagbe.1@13126.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brownsville Community Development Corporation

  dba Brownsville MultiService Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Brooklyn, NY
  • NPI 1578612412
  Medicare reassignment Care Compare group NPD
• Interfaith Professional Physician Services, P.C.

  dba OBH Physician Associates

  • Surgery Physician
  • Brooklyn, NY
  • NPI 1457643991

  Gastroenterology

  Medicare reassignment Care Compare group NPD
• Olusegun M Adeonigbagbe MDPC

  • Endoscopy Clinic/Center
  • Hollis, NY
  • NPI 1336474287
  Medicare reassignment NPD Authorized official
• Kingsbrook Medical Associates, PC

  • Multi-Specialty Clinic/Center
  • Brooklyn, NY
  • NPI 1104112838
  Medicare reassignment NPD
• Brownsville Community Development Corporation

  • Urgent Care Clinic/Center
  • Brooklyn, NY
  • NPI 1316681430
  NPD
• Interfaith Emergency Medicine, P.C.

  dba OBH Emergency Medicine Physicians

  • Emergency Medicine Physician
  • Brooklyn, NY
  • NPI 1457643785
  NPD
• Kingsbrook Medical Associates PC

  • Emergency Medicine Physician
  • Brooklyn, NY
  • NPI 1770844797
  NPD
• CMC Radiological Services PC

  dba St Vincents Catholic Medical Center

  • Diagnostic Radiology Physician
  • Elmhurst, NY
  • NPI 1093851990
  NPD (past)
• CMC Radiological Services PC

  dba St Vincents Catholic Medical Center

  • Diagnostic Radiology Physician
  • Jamaica, NY
  • NPI 1285780502
  NPD (past)
• Flatbush Medical Heights Services P.C.

  • Legal Medicine
  • Brooklyn, NY
  • NPI 1952380073
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Brookdale Hospital Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1346380870
  Care Compare affiliation
• The Brookdale Hospital Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1356307656
  Care Compare affiliation
• The Brookdale Hospital Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1487724712
  Care Compare affiliation
• The Brookdale Hospital Medical Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Brooklyn, NY
  • NPI 1639756406

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217808000000",
    "number": "1073570081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 NORFOLK DRIVE E",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "11003",
            "telephone_number": "718-217-7744",
            "fax_number": "718-217-7233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19203 JAMAICA AVE",
            "city": "HOLLIS",
            "state": "NY",
            "postal_code": "114232529",
            "telephone_number": "718-217-7744",
            "fax_number": "718-217-7233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEONIGBAGBE",
        "first_name": "OLUSEGUN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2008-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "201260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI MEDICARE",
            "identifier": "03590",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3V1542",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P1300262",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "3C2885",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "QN0067201",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "201260",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2588825",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01624886",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "2506098",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPLUS",
            "identifier": "000333540101",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREPLUS",
            "identifier": "111948722AD03",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH FIRST",
            "identifier": "201260-A16",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00010034",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sibila Abramov
• Lourdes Acay Santos
• Gianna L Acosta, LCSW
• Lawanna Adkins
• Advanced Dental of New York PC (Advanced Dental Specialties of NY)
• Doina G Agbary, DDS
• Laurena Agnant
• Bhaveshkumar B Ahir

• Gastroenterology Physician in Hollis, NY
• Providers in Hollis, NY by specialty
• Gastroenterology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; 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.