Adekola Adedeji, MD, MPH
Individual provider Active NPI Infectious Disease Physician · Bridgeport, CT
NPI 1285190843 · NPPES record last updated Aug 12, 2024
Key facts
- NPI
- 1285190843
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Infectious Disease Physician 207RI0200X
- License
- 69252 (CT)
- Practice address
- 2800 Main St
Bridgeport, CT 06606-4201 - Phone
- (203) 382-2100
- NPI assigned
- Feb 19, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220509002181 | CT | Practitioner - Infectious Disease |
9931431004 | Practice locations: East Hartford, CT |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 69252 | CT | MD | Infectious Disease Physician |
| D0096245 | MD | MD | Infectious Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cornerstone Practice | Current |
Accepting new patients |
Locations
585 Burnside Ave
East Hartford, CT 06108
Phone (860) 781-7123
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician | 207RI0200X | D0096245 | MD | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Infectious Disease Physician | 207RI0200X | 69252 | CT | Yes |
Addresses
Primary practice location
2800 Main St
Bridgeport, CT 06606-4201
Mailing address
Ochsner Health System
1501 Kings Highway
Shreveport, LA 71130
Phone (318) 626-0506
Other providers in Bridgeport, CT
- Erica Lynn Acquarulo
- Madeline Acquilano
- Harry Adamakos
- Barbara Addi
- Babajide Adebusoye
- Zosimo Adefuin
- Mayowa Abiola Adefuye
- Abena Ohenewah Adei
- Jite Tobore Adeniran
- Nishob Adhikari
All providers in Bridgeport, CT · Infectious Disease Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.