NPIMap

Individual provider Active NPI

Olatokunbo Madupe Adeniyi, M.D.

  • Internal Medicine Physician
  • Harrisburg, PA
National Provider Identifier
1174621809
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD464185 Issued in PA
Practice address
5125 Jonestown Rd Ste 105
Harrisburg, PA 17112-2987
Phone
(717) 943-1566
NPI assigned
Sep 20, 2006
Last updated
Sep 24, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2018

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35.133438 OH
Internal Medicine Physician 207R00000X 21580 WV
Internal Medicine Physician 207R00000X MD464185 PA Primary
Pediatrics Physician 208000000X 21580 WV
Pediatrics Physician 208000000X 35.133438 OH

Addresses

Primary practice location

5125 Jonestown Rd Ste 105
Harrisburg, PA 17112-2987

Mailing address

5000 Cox Rd
Glen Allen, VA 23060-9263
Phone (804) 968-5700

Other practice location 1

1901 Argonne Rd
Portsmouth, OH 45662-2827
Phone (740) 991-0911

Other practice location 2

429 Smithfield St
Anmoore, WV 26323
Phone (304) 623-6300

Other identifiers 1

IdentifierTypeStateIssuer
3810000897MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, PA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040824001498 WV Practitioner - General PracticePractitioner - Internal MedicinePractitioner - Pediatric Medicine 0244204204 Reassigns benefits to 2 organizations
I20180625002605 PA Practitioner - Pediatric MedicinePractitioner - Internal Medicine 0244204204 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Personal Care Medical Associates, LLCGroup PAC ID 1456344084, 64 clinicians
SNF Specialty ServicesGroup PAC ID 3375989668, 56 clinicians

Practice addresses (Care Compare)

2000 Cliffmine Rd
Suite 500
Pittsburgh, PA 15275-1053
Phone (878) 201-3312

2395 Lancaster Pike
FL 1
Reading, PA 19607-2375
Phone (570) 561-2990

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians Internal Medicine CurrentSince Jul 1, 2018 Accepting new patients
Summers Emergency Physicians LLC CurrentSince Oct 5, 2019 Accepting new patients
University of Pittsburgh Physicians CurrentSince Jul 1, 2018 Accepting new patients
Primary Care Health Services Inc CurrentSince Sep 15, 2024 Accepting new patients
Primary Care Health Services, Inc. CurrentSince Sep 15, 2024 Accepting new patients
Beckley Emergency Physicians LLC CurrentSince Mar 23, 2020 Accepting new patients
Absolutecare of Philadelphia, LLC Current Accepting new patients
Primary Care Health Services, Inc. Current Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients
Absolutecare of Philadelphia, LLC CurrentSince Jul 1, 2022 Accepting new patients
Hles of Ohio, Inc. Current Accepting new patients
Personal Care Medical Associates LLC CurrentSince Dec 1, 2025 Accepting new patients
Kittanning Health & Rehab Center, LLC Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
United Vascular & Vein Center PLLC PastSince Oct 22, 2014 Accepting new patients
United Hospital Center, Inc. Internal Medicine Past Accepting new patients
Premier Medical Group, Inc. Past Accepting new patients

Locations

10175 Little Patuxent Pkwy
Ste 800
Columbia, MD 21044

1460 Orange St
Coshocton, OH 43812
Phone (740) 545-7919

200 Lothrop St
Pittsburgh, PA 15213
Phone (412) 647-3553

2000 Cliffmine Rd
Ste 500
Pittsburgh, PA 15275
Phone (724) 766-0025

7225 Hamilton Ave
Pittsburgh, PA 15208
Phone (412) 244-4700

7301 Penn Ave
Pittsburgh, PA 15208
Phone (412) 512-3000

5230 Centre Ave
Shadyside, PA 15232
Phone (412) 623-2167

306 Stanaford Rd
Beckley, WV 25801
Phone (304) 255-3373

115 Summers Hospital Rd
Hinton, WV 25951
Phone (304) 466-2918

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1174621809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 COX RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609263",
            "telephone_number": "804-968-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5125 JONESTOWN RD STE 105",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171122987",
            "telephone_number": "717-943-1566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 Argonne Rd",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "OH",
            "postal_code": "456622827",
            "country_code": "US",
            "telephone_number": "740-991-0911",
            "fax_number": "740-991-6050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "429 SMITHFIELD ST",
            "address_purpose": "LOCATION",
            "city": "ANMOORE",
            "state": "WV",
            "postal_code": "26323",
            "country_code": "US",
            "telephone_number": "304-623-6300",
            "fax_number": "304-623-1006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADENIYI",
        "first_name": "OLATOKUNBO",
        "middle_name": "MADUPE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.133438",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "21580",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD464185",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WV",
            "license": "21580",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.133438",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810000897",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.