Adepeju Bolanle George, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA17876 Issued in CA

Practice address

8233 E Stockton Blvd Ste D
Sacramento, CA 95828-8203

Phone

(916) 368-3080

Fax

(916) 405-6551

NPI assigned

Dec 9, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: adepeju.george.p1@direct.csvs.nextgenshare.com
• Direct secure messaging: ageorge14015@hpmg.direct-ci.net

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.

• Ampla Health

  • Federally Qualified Health Center (FQHC)
  • Oroville, CA
  • NPI 1952333635
  Medicare reassignment NPD (past)
• Bola Home Health Agency LLC

  • Home Health Agency
  • Sacramento, CA
  • NPI 1790408276
  NPD Authorized official
• Ampla Health

  • Federally Qualified Health Center (FQHC)
  • Gridley, CA
  • NPI 1639194004
  NPD
• Ampla Health

  • Federally Qualified Health Center (FQHC)
  • Chico, CA
  • NPI 1881613669
  NPD

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

{
    "created_epoch": "1165622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447632000000",
    "number": "1316007685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9999 CORTINO WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957573052",
            "telephone_number": "916-879-4157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8233 E STOCKTON BLVD STE D",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958288203",
            "telephone_number": "916-368-3080",
            "fax_number": "916-405-6551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "ADEPEJU",
        "middle_name": "BOLANLE",
        "name_prefix": "Mrs.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-09",
        "last_updated": "2015-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA17876",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17876",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA17876",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tejoun Edwin Gentry Johnson
• Alice Gentry
• Jelan Antonio Gentry
• Stephen A Genus, D.M.D.
• Stephanie Lynn George-Mello, LMFT, APCC
• Amy George, M.D.
• Bernadette Mary George
• Jason Carl George, PA-C
• Jodie George, MA, LMFT
• Joshua David George, MD

• Medical Physician Assistant in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2015; 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.