Bamidele Adeoye Fagbola, DNP, AGPCNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN2301773 Issued in MA

Practice address

534 Prospect St
Fall River, MA 02720-5281

Phone

(508) 973-7766

Fax

(508) 973-7753

NPI assigned

Jun 25, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Southcoast Physicians Group, Inc.

  • Family Medicine Physician
  • Fairhaven, MA
  • NPI 1336137629
  Medicare reassignment NPD
• Southcoast Physicians Group, Inc.

  • Orthopaedic Surgery Physician
  • North Dartmouth, MA
  • NPI 1902201536
  NPD

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

{
    "created_epoch": "1624579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1265002075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILL RD",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027195252",
            "telephone_number": "508-973-2000",
            "fax_number": "508-973-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "534 PROSPECT ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027205281",
            "telephone_number": "508-973-7766",
            "fax_number": "508-973-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGBOLA",
        "first_name": "BAMIDELE",
        "middle_name": "ADEOYE",
        "name_prefix": "Dr.",
        "credential": "DNP, AGPCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-25",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2301773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Everett
• Eye Health Associates Inc
• Eye Health Associates Inc
• Eye Health Vision Centers,LLC
• Elizabeth Anne Ezaki
• Maria Fagundes
• Osman Faheem, M.D.
• Courtney L Faiola, RD, LDN
• Bridgett K Fairweather
• Stephanie M Falk, NP

• Nurse Practitioner in Fall River, MA
• Providers in Fall River, MA by specialty
• Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.