Individual provider Active NPI

Adebowale Mofikoya, M.D.

  • Psychiatry Physician
  • Sun Prairie, WI
National Provider Identifier
1275794422
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
60574 Issued in WI
Practice address
425 W Main St Ste 201
Sun Prairie, WI 53590-2971
Phone
(608) 318-2233
NPI assigned
Jun 20, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 60574 WI
Psychiatry Physician 2084P0800X 60574 WI Primary

Addresses

Primary practice location

425 W Main St Ste 201
Sun Prairie, WI 53590-2971

Mailing address

425 W Main St Ste 201
Sun Prairie, WI 53590-2971
Phone (608) 318-2233

Other identifiers 1

IdentifierTypeStateIssuer
100031050MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20130726000394 WI Practitioner - Psychiatry 0143477166 Reassigns benefits to 11 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercyland Psychiatry IncGroup PAC ID 3274897897, 2 clinicians

Practice addresses (Care Compare)

425 W Main St
Suite 201
Sun Prairie, WI 53590-2971
Phone (608) 318-2233

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60574WIMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Mar 1, 2019 Accepting new patients
Mercyland Psychiatry Inc Child & Adolescent Psychiatry CurrentSince Apr 18, 2018 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc CurrentSince Mar 1, 2019 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Mar 1, 2019 Accepting new patients
Agnesian Healthcare Inc CurrentSince Jul 15, 2013 Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince Mar 1, 2019 Accepting new patients
Aspirus Eagle River Hospital & Clinics, Inc. Current Accepting new patients
Aspirus Stanley Hospital & Clinics, Inc. CurrentSince Mar 1, 2019 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee Inc CurrentSince Mar 1, 2019 Accepting new patients
Ascension Medical Group-Southeast Wisconsin Inc CurrentSince Feb 12, 2019 Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince Mar 1, 2019 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc Current Accepting new patients
Aspirus Eagle River Hospital, Inc. CurrentSince Mar 1, 2019 Accepting new patients
Agnesian Healthcare, Inc CurrentSince Jul 15, 2013 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Mar 1, 2019 Accepting new patients
The Howard Young Medical Center, Inc. CurrentSince Mar 1, 2019 Accepting new patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Mar 1, 2019 Accepting new patients
Aspirus Stanley Hospital & Clinics, Inc CurrentSince Mar 1, 2019 Accepting new patients
Aspirus Merrill Hospital & Clinics, Inc. CurrentSince Mar 1, 2019 Accepting new patients
Aspirus Merrill Hospital & Clinics, Inc. CurrentSince Mar 1, 2019 Accepting new patients
Clark County Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

1501 S Madison St
Appleton, WI 54915
Phone (920) 730-4435

1506 S Oneida St
Appleton, WI 54915
Phone (920) 730-4950

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

614 Memorial Dr
Chilton, WI 53014
Phone (800) 458-4042

201 Hospital Rd
Eagle River, WI 54521
Phone (715) 477-3000

420 E Division St
Fond du Lac, WI 54935
Phone (920) 923-7400

430 E Division St
Fond du Lac, WI 54935
Phone (920) 926-4200

10101 S 27th St
Franklin, WI 53132
Phone (414) 325-4700

601 S Center Ave
Merrill, WI 54452
Phone (715) 536-5511

3237 S 16th St
Milwaukee, WI 53215
Phone (414) 647-5000

500 S Oakwood Rd
Oshkosh, WI 54904
Phone (920) 223-0501

2700 W 9th Ave
Oshkosh, WI 54904
Phone (920) 223-0220

2251 N Shore Dr
Ste 100
Rhinelander, WI 54501
Phone (715) 361-2074

1120 Pine St
Stanley, WI 54768
Phone (715) 644-5530

900 Illinois Ave
Stevens Point, WI 54481
Phone (715) 342-7500

425 W Main St
Ste 201
Sun Prairie, WI 53590
Phone (608) 318-2233

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

401 W Mohawk Dr
Ste 100
Tomahawk, WI 54487
Phone (715) 453-7700

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600

3400 Ministry Pkwy
Weston, WI 54476
Phone (715) 393-1000

240 Maple St
Woodruff, WI 54568
Phone (715) 356-8000

Interoperability endpoints

  • Direct secure messaging: adebowale.mofikoya.1@26294.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/26294/brand/1/csg/1/fhir/r4

Organizations & group practices 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1275794422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 W MAIN ST STE 201",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535902971",
            "telephone_number": "608-318-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W MAIN ST STE 201",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535902971",
            "telephone_number": "608-318-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFIKOYA",
        "first_name": "ADEBOWALE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-20",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WI",
            "license": "60574",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "60574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100031050",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun Prairie, WI

Sources for this page

Verify at the official NPI Registry.