Individual provider Active NPI

Andrea Baowang Ajayi, MD

  • Emergency Medicine Physician
  • Oakland, CA
National Provider Identifier
1164413472
Registry record updated Jul 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A72668 Issued in CA
Practice address
1800 Harrison St
7TH Floor
Oakland, CA 94612-3466
Phone
(510) 625-6262
Fax
(510) 625-6226
NPI assigned
Nov 4, 2005
Last updated
Jul 6, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A72668 CA Primary

Addresses

Primary practice location

1800 Harrison St
7TH Floor
Oakland, CA 94612-3466

Mailing address

5714 Eastview Dr
Stockton, CA 95212-2526
Phone (209) 747-5918

Other identifiers 1

IdentifierTypeStateIssuer
00A726880MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20051025000333 CA Practitioner - Emergency Medicine 2668499120 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Loma Linda University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - CaliforniaGroup PAC ID 6103739131, 1,278 clinicians

Practice addresses (Care Compare)

1700 Coffee Rd
Modesto, CA 95355-2803
Phone (209) 526-4500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America - California Emergency Medicine CurrentSince Jun 1, 2013 Accepting new patients
Team Physicians of California Medical Group Inc Emergency Medicine CurrentSince Jul 10, 2013 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Jun 1, 2013 Accepting new patients

Locations

3901 Lone Tree Way
Antioch, CA 94509
Phone (925) 779-7200

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1650 Creekside Dr
Folsom, CA 95630
Phone (916) 983-7400

500 W Hospital Rd
French Camp, CA 95231
Phone (209) 468-6000

1235 W Vine St
Ste 20
Lodi, CA 95240
Phone (209) 339-7410

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

520 W I St
Los Banos, CA 93635
Phone (209) 724-0316

1441 Florida Ave
Modesto, CA 95350
Phone (209) 214-7235

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1700 Coffee Rd
Modesto, CA 95355
Phone (209) 526-4500

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

1 Medical Plaza Dr
Roseville, CA 95661
Phone (916) 781-1000

2801 L St
Sacramento, CA 95816
Phone (916) 454-2222

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

525 W Acacia St
Stockton, CA 95203
Phone (209) 944-5410

825 Delbon Ave
Turlock, CA 95382
Phone (209) 664-2744

Interoperability endpoints

  • Direct secure messaging: aajayi308751@hisp.ehr.sutterhealth.org

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.

Hospital & facility affiliations 2

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": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246838400000",
    "number": "1164413472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5714 EASTVIEW DR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952122526",
            "telephone_number": "209-747-5918",
            "fax_number": "209-931-1285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 HARRISON ST",
            "address_2": "7TH FLOOR",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123466",
            "telephone_number": "510-625-6262",
            "fax_number": "510-625-6226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJAYI",
        "first_name": "ANDREA",
        "middle_name": "BAOWANG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-04",
        "last_updated": "2009-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A72668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A726880",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.