Individual provider Active NPI

Oladimeji Jacobs Alade, D.O.

  • Psychiatry Physician
  • Bowie, MD
National Provider Identifier
1366698128
Registry record updated May 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
H83240 Issued in MD
Practice address
14300 Gallant Fox LN Ste 103
Bowie, MD 20715-4031
Phone
(240) 594-0350
Fax
(240) 594-0350
NPI assigned
Aug 13, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X H83240 MD Primary

Addresses

Primary practice location

14300 Gallant Fox LN Ste 103
Bowie, MD 20715-4031

Mailing address

14300 Gallant Fox LN Ste 103
Bowie, MD 20715-4031
Phone (240) 594-0350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20190606000965 MD Practitioner - Psychiatry 8820366800 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Health Services LLC Psychiatry CurrentSince Feb 19, 2023 Accepting new patients

Locations

14300 Gallant Fox Ln
Ste 103
Bowie, MD 20715
Phone (240) 594-0350

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589500800000",
    "number": "1366698128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14300 GALLANT FOX LN STE 103",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207154031",
            "telephone_number": "240-594-0350",
            "fax_number": "240-594-0350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14300 GALLANT FOX LN STE 103",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207154031",
            "telephone_number": "240-594-0350",
            "fax_number": "240-594-0350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALADE",
        "first_name": "OLADIMEJI",
        "middle_name": "JACOBS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-13",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "H83240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

Verify at the official NPI Registry.