Individual provider Active NPI

Ajibola Adekanye, APRN

  • Psychiatric/Mental Health Registered Nurse
  • Hamden, CT
National Provider Identifier
1144988841
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
10255 Issued in CT
Practice address
196 W Side Dr
Hamden, CT 06514-3727
Phone
(203) 873-8021
NPI assigned
Nov 30, 2021
Last updated
May 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 010255 CT
Psychiatric/Mental Health Registered Nurse 163WP0808X 10255 CT Primary

Addresses

Primary practice location

196 W Side Dr
Hamden, CT 06514-3727

Mailing address

196 W Side Dr
Hamden, CT 06514-3727
Phone (203) 873-8021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220103000233 CT Practitioner - Nurse Practitioner 5294126116 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of ConnecticutGroup PAC ID 8022915677, 267 clinicians
Step Up Care PC LLCGroup PAC ID 5496088346, 176 clinicians

Practice addresses (Care Compare)

1635 Central Ave
Bridgeport, CT 06610-2717
Phone (203) 551-7464

5 Greenwood St
Hartford, CT 06106-2110
Phone (718) 298-4375

Merit-based Incentive Payment System (MIPS)

Final score
87.14 of 100Reported as group
Quality
71.85
Improvement activities
40
Cost
75.41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010255CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Step Up Care PC LLC CurrentSince Nov 21, 2021 Accepting new patients
State of Connecticut CurrentSince Jul 1, 2022 Accepting new patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Apr 30, 2025 Accepting new patients
State of Connecticut CurrentSince Jul 1, 2022 Accepting new patients

Locations

1635 Central Ave
Bridgeport, CT 06610
Phone (203) 551-7464

100 Pearl St
Fl 14
Hartford, CT 06103
Phone (860) 421-6636

450 Columbus Blvd
Ste 1001
Hartford, CT 06103

5 Greenwood St
Hartford, CT 06106
Phone (860) 236-2901

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

27 Randolph Rd
#A
Howell, NJ 07731
Phone (732) 797-9290

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1638230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1144988841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 W SIDE DR",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065143727",
            "telephone_number": "203-873-8021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 W SIDE DR",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065143727",
            "telephone_number": "203-873-8021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEKANYE",
        "first_name": "AJIBOLA",
        "name_prefix": "Dr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-30",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "010255",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CT",
            "license": "10255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamden, CT

Sources for this page

Verify at the official NPI Registry.