Active NPI
Adewale Adefowoju, MSN, APN-BC
- Nurse Practitioner
- Union, NJ
National Provider Identifier
1114153186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 26NJ00196200
- Practice address
- 1379 Brookfall Ave
Union, NJ 07083-7013 - Phone
- (908) 693-5036
- NPI assigned
- Jun 4, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
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.
-
- Psychiatric/Mental Health Nurse Practitioner
- Irvington, NJ
- NPI 1104370915
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Newark, NJ
- NPI 1689074601
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Hoboken, NJ
- NPI 1881217685
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Newark, NJ
- NPI 1174854749
-
- Clinical Social Worker
- Lakewood, NJ
- NPI 1821036302
-
- Psychiatry Physician
- Irvington, NJ
- NPI 1134634462
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Newark, NJ
- NPI 1477792463
-
- Psychologist
- Philadelphia, PA
- NPI 1952570558
NPD (past) NURSE PRACTITIONER
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
- Mount Carmel Guild Behavioral Health
Practice addresses (Care Compare)
285 Magnolia Ave
Jersey City, NJ 07306-3906
Phone (201) 395-4800
40 Union Ave
Irvington, NJ 07111-3277
Phone (862) 849-2618
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Medicare enrollment records 1
Medicare enrollment files| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090709000286 | NJ | Practitioner - Nurse Practitioner | 1850443615 | Reassigns benefits to 2 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NJ00196200 | NJ | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mount Carmel Guild Behavioral Health System | Current | Accepting new patients | |
| Mount Carmel Guild Behavioral Health System | Current | Accepting new patients | |
| Grace Medical Care | Current | Accepting new patients | |
| Grace Medical Consult | Current | Accepting new patients | |
| Advanced Behavioral Health | Nurse Practitioner | Past | Accepting new patients |
| Comprehensive Geriatric Care LLC | Past | Accepting new patients | |
| Sunrise Care, LLC | Past | Accepting new patients | |
| L&a Absolute Care LLC | Past | Accepting new patients |
Locations
40 Union Ave
Ste 301
Irvington, NJ 07111
Phone (862) 849-2618
285 Magnolia Ave
Jersey City, NJ 07306
Phone (201) 395-4300
2201 Bergenline Ave
Union City, NJ 07087
Phone (201) 558-3700
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 26NJ00196200 | NJ | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
1379 Brookfall Ave
Union, NJ 07083-7013
Mailing address
1379 Brookfall Ave
Union, NJ 07083-7013
Phone (908) 693-5036
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 20, 2011.
{
"created_epoch": "1244073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303257600000",
"number": "1114153186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1379 BROOKFALL AVE",
"city": "UNION",
"state": "NJ",
"postal_code": "070837013",
"telephone_number": "908-693-5036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1379 BROOKFALL AVE",
"city": "UNION",
"state": "NJ",
"postal_code": "070837013",
"telephone_number": "908-693-5036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADEFOWOJU",
"first_name": "ADEWALE",
"credential": "MSN, APN-BC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-04",
"last_updated": "2011-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NJ",
"license": "26NJ00196200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Union, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2011; 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.