Olalekan Henry Ajibowo, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

059896 Issued in GA

Practice address

413 Pottery Factory Dr
Commerce, GA 30529-6682

Phone

(706) 423-9449

Fax

(706) 423-9443

NPI assigned

Aug 6, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Internal MedicineAlso: Hospitalist

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emory Specialty Associates, LLC 706 clinicians

Georgia Physician Associates PC 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Emory Hillandale Hospital Hospital, Lithonia, GA, CCN 110226

Merit-based Incentive Payment System (MIPS)

Final score

94.51 of 100Reported as apm

Quality

80.61

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: oajibowo32335@direct.emory.org

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.

• Emory Specialty Associates, LLC

  • Anesthesiology Physician
  • Lagrange, GA
  • NPI 1407864168

  GA, Internal Medicine

  Medicare reassignment Care Compare group NPD
• Georgia Physician Associates, PC

  • Specialist
  • Canton, GA
  • NPI 1528496353

  GA

  Medicare reassignment Care Compare group
• Cogent Healthcare of Georgia PC

  • Internal Medicine Physician
  • Macon, GA
  • NPI 1609827823

  GA, Internal Medicine

  Medicare reassignment NPD
• CFS Health Management

  • Specialist
  • Canton, GA
  • NPI 1528479870
  NPD
• Dima Care, Inc

  • Family Medicine Physician
  • Commerce, GA
  • NPI 1699340612
  NPD

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

• Dekalb Medical Center, Inc.

  • General Acute Care Hospital
  • Lithonia, GA
  • NPI 1962403865

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481500800000",
    "number": "1235320151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 POTTERY FACTORY DR",
            "city": "COMMERCE",
            "state": "GA",
            "postal_code": "305296682",
            "telephone_number": "706-423-9449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 POTTERY FACTORY DR",
            "city": "COMMERCE",
            "state": "GA",
            "postal_code": "305296682",
            "telephone_number": "706-423-9449",
            "fax_number": "706-423-9443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJIBOWO",
        "first_name": "OLALEKAN",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-06",
        "last_updated": "2016-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "059896",
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "GA",
            "license": "059896",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "GA",
            "license": "059896",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "GA",
            "license": "059896",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012327700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029471605E",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029471605K",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029471605L",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029471605M",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029471605I",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029471605C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029471605J",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robyne Levale Adams, OT
• Advantage BHS
• Affordable Dentures - Commerce,P.C.
• Affordable Dentures & Implants of Georgia II, LLC
• Melissa Aguilar
• Amedisys Georgia, LLC
• American Hearing Aid Centers, Inc.
• American Hearing Aid Centers, Inc.
• Arch 2 Arch LLC
• Ardavan Askari, DDS

• All providers in Commerce, GA
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.