NPIMap

Individual provider Active NPI

Oladapo A Odujebe, MD

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1184654014
Registry record updated Jun 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25MA08145500 Issued in NJ
Practice address
5501 Old York Rd
Department of Emergency Medicine
Philadelphia, PA 19141-3018
Phone
(215) 456-6336
NPI assigned
Jul 4, 2006
Last updated
Jun 1, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD428043 PA
Emergency Medicine Physician 207P00000X 25MA08145500 NJ Primary
Emergency Medicine Physician 207P00000X 241272 NY

Addresses

Primary practice location

5501 Old York Rd
Department of Emergency Medicine
Philadelphia, PA 19141-3018

Mailing address

1 Soho Drive
Unit 102
Jersey City, NJ 07305-1138
Phone (732) 910-3276

Other identifiers 2

IdentifierTypeStateIssuer
0122734MedicaidNJ
P00357155OtherNJRAIL ROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080707000172 GA Practitioner - Emergency Medicine 6406853985 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Rutgers New Jersey Medical School, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Independence Emergency Physicians LLCGroup PAC ID 2264484971, 10 clinicians
Carrollton Emergency Physicians PCGroup PAC ID 7416860010, 34 clinicians

Practice addresses (Care Compare)

200 Allen Memorial Dr
Bremen, GA 30110-2012
Phone (770) 537-5851

705 Dixie St
Carrollton, GA 30117-3818
Phone (770) 812-9666

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD428043PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ben Hill Emergency Group LLC Emergency Medicine CurrentSince Aug 1, 2012 Accepting new patients
Independence Emergency Physicians LLC Emergency Medicine CurrentSince May 1, 2017 Accepting new patients
Baldwin Emergency Group, LLC Emergency Medicine CurrentSince Jul 24, 2017 Accepting new patients
Emergency Coverage, LLC Emergency Medicine CurrentSince Jan 20, 2016 Accepting new patients
Carrollton Emergency Physicians, PC Emergency Medicine CurrentSince Jan 1, 2013 Accepting new patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine CurrentSince Sep 1, 2019 Accepting new patients
Essex Emergency Group PC Emergency Medicine Past Accepting new patients
Csra Emergency Physicians Emergency Medicine Past Accepting new patients
Cherokee Emergency Services, LLC Past Accepting new patients

Locations

200 Allen Memorial Dr
Bremen, GA 30110
Phone (770) 537-5851

705 Dixie St
Carrollton, GA 30117
Phone (770) 812-9666

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

200 Industrial Blvd
Dublin, GA 31021
Phone (478) 274-3865

200 Perry House Rd
Fitzgerald, GA 31750
Phone (229) 424-1461

821 N Cobb St
Milledgeville, GA 31061
Phone (478) 454-3500

2151 W Spring St
Monroe, GA 30655
Phone (770) 267-1792

601 Dallas Hwy
Villa Rica, GA 30180
Phone (770) 456-3000

Organizations & group practices 10

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 3

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243814400000",
    "number": "1184654014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SOHO DRIVE",
            "address_2": "UNIT 102",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073051138",
            "telephone_number": "732-910-3276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413018",
            "telephone_number": "215-456-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODUJEBE",
        "first_name": "OLADAPO",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2009-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD428043",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA08145500",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "241272",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0122734",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00357155",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.