Active NPI
Temitope Ajagbe, M.D.
- Family Medicine Physician
- French Camp, CA
National Provider Identifier
1235511478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A151851
- Practice address
- 500 W Hospital Rd
French Camp, CA 95231-9693 - Phone
- (209) 468-6000
- Fax
- (209) 468-7042
- NPI assigned
- Jun 24, 2015
- Last updated
- Jun 1, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Family Medicine Physician | 207Q00000X | A151851 | CA | Primary |
Addresses
Primary practice location
500 W Hospital Rd
French Camp, CA 95231-9693
Mailing address
1499 W 1St St
San Pedro, CA 90732-3255
Phone (310) 241-2590
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tajagbe1181055@oc.providencedirect.org |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1499 W 1St St
San Pedro, CA 90732-3255
Phone (310) 831-9482
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A151851 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Medical Institute | Family Medicine | Current | Accepting new patients |
| Providence Medical Institute | Family Medicine | Current | Accepting new patients |
Locations
1499 W 1st St
San Pedro, CA 90732
Phone (310) 241-2590
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Organizations & group practices 2
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.
-
dba Providence Little Company of Mary Medical Institute
- Family Medicine Physician
- Torrance, CA
- NPI 1417915760
-
dba Providence Little Company of Mary Medical Institute
- Family Medicine Physician
- Torrance, CA
- NPI 1235182569
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Providence Little Company of Mary Medical Center San Pedro OBHC
- General Acute Care Hospital
- San Pedro, CA
- NPI 1497241541
-
dba Providence Little Company of Mary Medical Center San Pedro
- General Acute Care Hospital
- San Pedro, CA
- NPI 1942247291
-
dba Providence Little Company of Mary Medical Center Torrance
- General Acute Care Hospital
- Torrance, CA
- NPI 1902844988
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435104000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622505600000",
"number": "1235511478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1499 W 1ST ST",
"city": "SAN PEDRO",
"state": "CA",
"postal_code": "907323255",
"telephone_number": "310-241-2590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 W HOSPITAL RD",
"city": "FRENCH CAMP",
"state": "CA",
"postal_code": "952319693",
"telephone_number": "209-468-6000",
"fax_number": "209-468-7042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AJAGBE",
"first_name": "TEMITOPE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-24",
"last_updated": "2021-06-01",
"certification_date": "2021-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A151851",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tajagbe1181055@oc.providencedirect.org",
"affiliation": "N",
"address_1": "1499 W 1st St",
"city": "San Pedro",
"state": "CA",
"country_code": "US",
"postal_code": "907323255",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in French Camp, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; 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.