Individual provider Active NPI

Abayomi O Ige, M.D.

  • Psychiatry Physician
  • Philadelphia, PA
National Provider Identifier
1184620130
Registry record updated Jun 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD060130L Issued in PA
Practice address
1315 Windrim Ave
Philadelphia, PA 19141-2710
Phone
(215) 455-3900
NPI assigned
Jun 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD060130L PA Primary
Child & Adolescent Psychiatry Physician 2084P0804X MD060130L PA

Addresses

Primary practice location

1315 Windrim Ave
Philadelphia, PA 19141-2710

Mailing address

870 Field Crest CT
Blue Bell, PA 19422-1301
Phone (215) 456-4068

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20060119000422 PA Practitioner - PsychiatryPractitioner - Addiction Medicine 4183648967 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Eastern Pennsylvania Physician Alliance, LLCGroup PAC ID 8325478662, 112 clinicians

Practice addresses (Care Compare)

1315 Windrim Ave
Philadelphia, PA 19141-2710
Phone (215) 455-3900

6404 Roosevelt Blvd
Philadelphia, PA 19149-2943
Phone (215) 660-7990

722 E Butler Pike
Ambler, PA 19002-2310
Phone (215) 643-7800

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
78.42
Improvement activities
40
Cost
70.24

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Pennsylvania Physician Alliance LLC Child & Adolescent Psychiatry CurrentSince Jun 1, 2020 Accepting new patients
Life Revival LLC Psychiatry CurrentSince Jan 26, 2025 Accepting new patients
Dr Warren E Smith Community Mental Health Mental Retardation & Substan CurrentSince Feb 21, 2009 Accepting new patients

Locations

2 Hospital Dr
Clarion, PA 16214
Phone (800) 253-4906

722 E Butler Pike
Maple Glen, PA 19002
Phone (215) 643-7800

1315 Windrim Ave
Philadelphia, PA 19141
Phone (215) 455-3900

6404 Roosevelt Blvd
Philadelphia, PA 19149
Phone (215) 660-7990

561 Fairthorne Ave
Philadelphia, PA 19128
Phone (215) 487-4000

4641 E Roosevelt Blvd
Philadelphia, PA 19124
Phone (215) 831-4600

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.

NPI Registry JSON

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309219200000",
    "number": "1184620130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 FIELD CREST CT",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194221301",
            "telephone_number": "215-456-4068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 WINDRIM AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191412710",
            "telephone_number": "215-455-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IGE",
        "first_name": "ABAYOMI",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2011-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD060130L",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PA",
            "license": "MD060130L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.