Individual provider Active NPI

Adebayo Olagoke Esan, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Brooklyn, NY
National Provider Identifier
1083807515
Registry record updated Jun 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
245706 Issued in NY
Practice address
9452 Ridge Blvd
Unit 2
Brooklyn, NY 11209-6708
Phone
(516) 387-2499
Fax
(888) 896-8771
NPI assigned
Aug 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 245706 NY
Pulmonary Disease Physician 207RP1001X 245706 NY
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 245706 NY Primary

Addresses

Primary practice location

9452 Ridge Blvd
Unit 2
Brooklyn, NY 11209-6708

Mailing address

9452 Ridge Blvd
Unit 2
Brooklyn, NY 11209-6708
Phone (516) 387-2499

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080813000104 NY Practitioner - Critical Care (Intensivists)Practitioner - Internal MedicinePractitioner - Pulmonary Disease 3072688951 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Pulmonary Disease
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interfaith Professional Physician Services PCGroup PAC ID 9931378171, 383 clinicians

Practice addresses (Care Compare)

1 Brookdale PLZ
Brooklyn, NY 11212-3198

1545 Atlantic Ave
Brooklyn, NY 11213-1122
Phone (718) 613-4000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
245706NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brookdale Hospital Medical Center CurrentSince Nov 1, 2018 Accepting new patients
Interfaith Professional Physician Services, P.C. Internal Medicine CurrentSince Jan 15, 2024 Accepting new patients
The Brookdale Hospital Medical Center CurrentSince Nov 1, 2018 Accepting new patients

Locations

1 Brookdale Plz
Brooklyn, NY 11212
Phone (718) 240-5212

1235 Linden Blvd
Fl 2
Brooklyn, NY 11212
Phone (718) 240-7143

1545 Atlantic Ave
Brooklyn, NY 11213
Phone (718) 613-4175

Networks

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

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1187308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434326400000",
    "number": "1083807515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9452 RIDGE BLVD",
            "address_2": "UNIT 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112096708",
            "telephone_number": "516-387-2499",
            "fax_number": "888-896-8771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9452 RIDGE BLVD",
            "address_2": "UNIT 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112096708",
            "telephone_number": "516-387-2499",
            "fax_number": "888-896-8771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESAN",
        "first_name": "ADEBAYO",
        "middle_name": "OLAGOKE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-17",
        "last_updated": "2015-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "245706",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "245706",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NY",
            "license": "245706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.