Jite Tobore Adeniran, M.D.
Individual provider Active NPI Internal Medicine Physician · Bridgeport, CT
NPI 1073965562 · NPPES record last updated Aug 28, 2019
Key facts
- NPI
- 1073965562
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- MD2019-0148 (NM)
- Practice address
- 2800 Main St
Bridgeport, CT 06606-4201 - Phone
- (202) 390-5943
- NPI assigned
- Jul 7, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Hospitalist
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Apogee Medical Group of Pennsylvania PC
Practice addresses (Care Compare)
232 W 25TH St
Erie, PA 16544-0002
Phone (814) 452-5000
Hospital & facility affiliations
- Saint Vincent Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.42 of 100
- Quality
- 75.58
- Improvement activities
- 40
- Cost
- 72.74
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- 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 |
|---|---|---|---|---|
| I20220307000039 | PA | Practitioner - Hospitalist |
7911237821 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Apogee Medical Group of Pennsylvania PC | Internal Medicine | Current |
Accepting new patients |
| Apogee Medical Group of Pennsylvania PC | Internal Medicine | Current |
Accepting new patients |
Locations
15059 N Scottsdale Rd
Ste 600
Scottsdale, AZ 85254
Phone (602) 778-3601
232 W 25th St
Erie, PA 16544
Phone (814) 452-5337
1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | MD2019-0148 | NM | Yes |
Addresses
Primary practice location
2800 Main St
Bridgeport, CT 06606-4201
Mailing address
2900 Main St Apt 332
Bridgeport, CT 06606-4210
Phone (202) 390-5943
Other providers in Bridgeport, CT
- Babajide Adebusoye
- Adekola Adedeji
- Zosimo Adefuin
- Mayowa Abiola Adefuye
- Abena Ohenewah Adei
- Nishob Adhikari
- Edin Adilovic
- Isaac Adjei Opoku
- Kwame Adjei-Sefah
- Yaw Amoateng Adjepong
All providers in Bridgeport, CT · Internal Medicine Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 28, 2019. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.