Amidat O Adeyemi, MD
Individual provider Active NPI Internal Medicine Physician · Augusta, GA
NPI 1366933236 · NPPES record last updated Jul 19, 2021
Key facts
- NPI
- 1366933236
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 89199 (GA)
- Practice address
- 1120 15TH St
Augusta, GA 30912-0004 - Phone
- (706) 721-2238
- NPI assigned
- May 25, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Wellstar Medical Group LLC
Practice addresses (Care Compare)
1120 15TH St
Augusta, GA 30912-0004
Phone (706) 721-8623
5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222
989 Saint Sebastian Way
Augusta, GA 30912-0004
Phone (706) 721-2171
Hospital & facility affiliations
- Wellstar MCG Health, Affiliated With Med Col
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.93 of 100
- Quality
- 82.14
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- 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 |
|---|---|---|---|---|
| I20210722003957 | GA | Practitioner - Internal Medicine | 6204189319 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009929 | GA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellstar Medical Group, LLC | Current |
Accepting new patients | |
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Wellstar Medical Group, LLC | Current |
Accepting new patients | |
| Au Medical Associates Inc | Current |
Accepting new patients | |
| Au Medical Associates Inc | Current |
Accepting new patients | |
| Au Medical Center, Inc | Past | Accepting new patients |
Locations
1120 15th St
Augusta, GA 30912
Phone (706) 721-3873
1120 15th St
#1056
Augusta, GA 30912
Phone (706) 721-3813
5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 89199 | GA | Yes |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
1120 15TH St
Augusta, GA 30912-0004
Mailing address
1120 15TH St
Augusta, GA 30912-0004
Other providers in Augusta, GA
- Addus Healthcare (South Carolina), Inc.
- Bamidele Adekunle Adeagbo
- Abiodun Adebiyi
- Michael Abiodun Adeleye
- Alaba Risikat Adeshigbin
- Raj Adhikari
- Ashley Adkins
- Jacob Randall Adkins
- Katie Adkins
- Lisa Michele Adkins
All providers in Augusta, GA · Internal Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 19, 2021. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.