Individual provider Active NPI

Oyeyemi A Adeyiga, PHD

  • Psychologist
  • Oklahoma City, OK
National Provider Identifier
1336589472
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1443 Issued in OK
Practice address
10525 Westover Ave
Oklahoma City, OK 73162-5628
Phone
(718) 864-1577
NPI assigned
Jul 3, 2013
Last updated
Dec 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6172 OK
Psychologist 103T00000X 1443 OK Primary

Addresses

Primary practice location

10525 Westover Ave
Oklahoma City, OK 73162-5628

Mailing address

10525 Westover Ave
Oklahoma City, OK 73162-5628

Other identifiers 1

IdentifierTypeStateIssuer
2004893890AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OK2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241023001293 TX Practitioner - Clinical Psychologist 8921531476 Reassigns benefits to 1 organization
I20241213001155 OK Practitioner - Clinical Psychologist 8921531476 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Betterway Psychiatric and Psychological ServicesGroup PAC ID 5496281438, 2 clinicians

Practice addresses (Care Compare)

500 N Meridian Ave
Suite I
Oklahoma City, OK 73107-5700
Phone (405) 373-6496

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6172OKMDProfessional Counselor
1443OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Citizen Potawatomi Nation CurrentSince Sep 23, 2024 Accepting new patients
Citizen Potawatomi Nation CurrentSince Sep 23, 2024 Accepting new patients
Betterway Psychiatric and Psychological Services CurrentSince Aug 26, 2024 Accepting new patients
Citizen Potawatomi Nation Current Accepting new patients
Luscent Counseling Services LLC Past Accepting new patients

Locations

4334 NW Expressway
Ste 281
Oklahoma City, OK 73116
Phone (405) 414-6446

2307 Gordon Cooper Dr
Shawnee, OK 74801
Phone (405) 273-5236

Interoperability endpoints

  • FHIR API: https://epicproxy.et1447.epichosted.com/APIProxyPRD/api/FHIR/R4

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1372809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1336589472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10525 WESTOVER AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731625628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10525 WESTOVER AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731625628",
            "telephone_number": "718-864-1577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEYIGA",
        "first_name": "OYEYEMI",
        "middle_name": "A",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-03",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "6172",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OK",
            "license": "1443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2004893890A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.