Individual provider Active NPI

Adekemi Oluseun Adedeji, D.O.

  • Hospitalist Physician
  • Cumming, GA
National Provider Identifier
1386949261
Registry record updated Jan 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
066237 Issued in GA
Practice address
1200 Northside Forsyth Dr
Cumming, GA 30041-7659
Phone
(770) 844-3200
Fax
(404) 851-6325
NPI assigned
Jan 24, 2011
Last updated
Jan 19, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OT012704 PA
Internal Medicine Physician 207R00000X 66237 GA
Hospitalist Physician 208M00000X 066237 GA Primary

Addresses

Primary practice location

1200 Northside Forsyth Dr
Cumming, GA 30041-7659

Mailing address

1200 Northside Forsyth Dr
Cumming, GA 30041-7659
Phone (770) 844-3200

Other identifiers 1

IdentifierTypeStateIssuer
003114062IMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111019000750 GA Practitioner - HospitalistPractitioner - Internal Medicine 1456523356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
New York College of Osteo Medicine of New York Institute of Technology, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Atlanta Professional Services LLCGroup PAC ID 0840291944, 423 clinicians

Practice addresses (Care Compare)

1200 Northside Forsyth Dr
Cumming, GA 30041-7659
Phone (770) 844-3200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.79 of 100Reported as group
Quality
98.74
Improvement activities
40
Cost
83.11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66237GAMDInternal Medicine Physician
OT012704PAMDInternal Medicine Physician
066237GAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Atlanta Professional Services LLC Hospitalist CurrentSince Aug 15, 2016 Accepting new patients
Northside Hospital, Inc. Past Accepting new patients
Dekalb Medical Hospitalists LLC Hospitalist Past Accepting new patients

Locations

1200 Northside Forsyth Dr
Cumming, GA 30041
Phone (770) 292-4806

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1295827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484784000000",
    "number": "1386949261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 NORTHSIDE FORSYTH DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417659",
            "telephone_number": "770-844-3200",
            "fax_number": "404-851-6325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 NORTHSIDE FORSYTH DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417659",
            "telephone_number": "770-844-3200",
            "fax_number": "404-851-6325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEDEJI",
        "first_name": "ADEKEMI",
        "middle_name": "OLUSEUN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-24",
        "last_updated": "2017-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OT012704",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "66237",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "066237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003114062I",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.