Individual provider Active NPI

Olayemi Iyabode Adedoja, DNP-CRNP

  • Family Nurse Practitioner
  • Charlotte Hall, MD
National Provider Identifier
1437747805
Registry record updated Jan 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R217668 Issued in MD
Practice address
9630 Trinity Church Rd
Charlotte Hall, MD 20622-3649
Phone
(240) 413-7635
NPI assigned
Jan 1, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R217668 MD Primary

Addresses

Primary practice location

9630 Trinity Church Rd
Charlotte Hall, MD 20622-3649

Mailing address

9630 Trinity Church Rd
Charlotte Hall, MD 20622-3649
Phone (240) 413-7635

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210423000538 MD Practitioner - Nurse Practitioner 2668880022 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mdics at Calvert LLCGroup PAC ID 6406017425, 26 clinicians
Mdics at Civista LLCGroup PAC ID 8325200793, 35 clinicians

Practice addresses (Care Compare)

100 Hospital Rd
Prince Frederick, MD 20678-4016
Phone (410) 535-4000

5 Garrett Ave
La Plata, MD 20646-5960
Phone (443) 949-0814

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.01 of 100Reported as group
Quality
78.53
Improvement activities
40
Cost
79.93

Merit-based Incentive Payment System (MIPS)

Final score
86.92 of 100Reported as group
Quality
82
Improvement activities
40
Cost
67.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R217668MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mdics at Calvert LLC CurrentSince Mar 21, 2021 Accepting new patients
Mdics at Civista LLC CurrentSince Jan 1, 2023 Accepting new patients

Locations

5 Garrett Ave
La Plata, MD 20646
Phone (301) 609-4000

100 Hospital Rd
Prnc Frederck, MD 20678
Phone (410) 414-4791

Interoperability endpoints

  • Direct secure messaging: oadedoja539101@direct.umm.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1609459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609459200000",
    "number": "1437747805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9630 TRINITY CHURCH RD",
            "city": "CHARLOTTE HALL",
            "state": "MD",
            "postal_code": "206223649",
            "telephone_number": "240-413-7635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9630 TRINITY CHURCH RD",
            "city": "CHARLOTTE HALL",
            "state": "MD",
            "postal_code": "206223649",
            "telephone_number": "240-413-7635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEDOJA",
        "first_name": "OLAYEMI",
        "middle_name": "IYABODE",
        "name_prefix": "Dr.",
        "credential": "DNP-CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-01",
        "last_updated": "2021-01-01",
        "certification_date": "2021-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R217668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte Hall, MD

Sources for this page

Verify at the official NPI Registry.