Adeola Adebusoye

Individual provider Active NPI Certified Registered Nurse Anesthetist · Laurel, MD

NPI 1609263268 · NPPES record last updated Apr 25, 2024

Key facts

NPI
1609263268
Entity type
Individual (NPI type 1)
Primary specialty
Certified Registered Nurse Anesthetist 367500000X
License
R175407 (MD)
Practice address
9419 3Rd St N
Laurel, MD 20723-1803
Phone
(240) 601-8865
NPI assigned
Apr 22, 2015
Sex
Female
Sole proprietor
Yes

Organizations & group practices 9

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.

Medicare Care Compare profile

Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Digestive Disease Associates LLC (46 clinicians)

Practice addresses (Care Compare)

10710 Charter Dr
Suite 120
Columbia, MD 21044-3258
Phone (410) 772-7345

Merit-based Incentive Payment System (MIPS)

Final score
63.85 of 100 (group)
Quality
57.47
Improvement activities
40

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in DC, MD

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160226000743 DC Practitioner - Certified Registered Nurse Anesthetist (Crna) 5193020212 Reassigns benefits to 4 organizations
I20160706000391 MD Practitioner - Certified Registered Nurse Anesthetist (Crna) 5193020212 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
R175407MDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Corridor Anesthesia, L.L.C. Nurse Anesthetist, Certified Registered Current
since Jul 1, 2021
Accepting new patients
Digestive Disease Associates, LLC Current
since Apr 1, 2021
Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Current
since Apr 30, 2017
Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Current Accepting new patients
First Colonies Anesthesia Associates, LLC Nurse Anesthetist, Certified Registered Current
since Mar 6, 2020
Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Current
since Apr 30, 2017
Accepting new patients
Laurel MD Endoscopy ASC LLC Current Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Current
since Apr 30, 2017
Accepting new patients
Newbridge Surgery Center at Prince Frederick, LLC Past Accepting new patients

Locations

851 Trafalgar Ct
Ste 200E
Maitland, FL 32751
Phone (321) 422-7155

700 Geipe Rd
Ste 230
Catonsville, MD 21228

700 Geipe Rd
Ste 220
Catonsville, MD 21228
Phone (410) 242-3636

10710 Charter Dr
Ste 110
Columbia, MD 21044
Phone (410) 992-9797

10710 Charter Dr
Ste 120
Columbia, MD 21044
Phone (410) 772-7345

400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300

301 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4565

1221 Mercantile Ln
Fl 3
Largo, MD 20774
Phone (301) 618-5500

7350 Van Dusen Rd
Ste 230
Laurel, MD 20707
Phone (301) 498-5500

11210 Old Georgetown Rd
#12202
Rockville, MD 20852
Phone (301) 881-7770

11210 Old Georgetown Rd
Rockville, MD 20852
Phone (301) 881-7770

46 W Gude Dr
Rockville, MD 20850
Phone (240) 750-6170

2101 E Jefferson St
Ste 6
Rockville, MD 20852

8322 Bellona Ave
Ste 201
Towson, MD 21204
Phone (410) 337-2688

1220C E Joppa Rd
Ste 508
Towson, MD 21286
Phone (410) 296-4415

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R175407 MD Yes

Addresses

Primary practice location

9419 3Rd St N
Laurel, MD 20723-1803

Mailing address

9419 3Rd St N
Laurel, MD 20723-1803

Electronic endpoints

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Other providers in Laurel, MD

All providers in Laurel, MD · Certified Registered Nurse Anesthetist in Maryland

Sources for this page

Verify at the official NPI Registry.