Active NPI
Omolara Grace Adeniran, MD
- Endocrinology, Diabetes & Metabolism Physician
- Brandon, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician
- License
- ME1683456
- Practice address
- 1721 Brandon Main St Ste D
Brandon, FL 33511-5018 - Phone
- (813) 977-2020
- Fax
- (813) 355-5010
- NPI assigned
- Jul 20, 2019
- Last updated
- Dec 12, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 445764 | NY | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | ME1683456 | FL | Primary |
Addresses
Primary practice location
1721 Brandon Main St Ste D
Brandon, FL 33511-5018
Mailing address
38135 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (352) 567-0188
Other practice location 1
450 Clarkson Ave
Brooklyn, NY 11203-2012
Phone (917) 701-3133
Other practice location 2
1 Brookdale Plz
Brooklyn, NY 11212-3139
Phone (718) 240-7630
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Endocrinology
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
14014 N 46TH St
Suite C
Tampa, FL 33613-4238
Phone (813) 284-2229
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 445764 | NY | MD | Internal Medicine Physician |
| ME1683456 | FL | MD | Endocrinology, Diabetes & Metabolism Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Suffolk Medical, P.C. | Current | Accepting new patients | |
| Ohi West Medical Group II LLC | Current | Accepting new patients | |
| Southwest Suffolk, P.C | Current | Accepting new patients | |
| Southwest Suffolk Medical PC | Current | Accepting new patients | |
| Ohi West Medical Group II LLC | Internal Medicine | Current | Accepting new patients |
| Ohi West Medical Group II LLC | Past | Accepting new patients |
Locations
1721 Brandon Main St
Ste C
Brandon, FL 33511
Phone (813) 973-1304
1721 Brandon Main St
Ste D
Brandon, FL 33511
Phone (813) 284-2220
14014 N 46th St
Ste C
Tampa, FL 33613
Phone (813) 284-2229
38135 Market Square Dr
Zephyrhills, FL 33542
Phone (352) 567-0188
38135 Market Square Dr
Ste 101
Zephyrhills, FL 33542
Phone (813) 788-7651
245 Old Country Rd
Melville, NY 11747
Phone (631) 465-6141
48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540
1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Organizations & group practices 6
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.
-
- General Practice Physician
- Zephyrhills, FL
- NPI 1982381299
Internal Medicine
-
- Surgical Oncology Physician
- Smithtown, NY
- NPI 1104096049
-
dba Florida Medical Clinic Orlando Health
- Durable Medical Equipment & Medical Supplies
- Wesley Chapel, FL
- NPI 1427814847
-
dba Samaritan Primary Care
- Family Medicine Physician
- Lindenhurst, NY
- NPI 1770919763
-
dba Siena Proactive Internal Medicine
- Family Medicine Physician
- Smithtown, NY
- NPI 1730428467
-
dba Florida Medical Clinic Orlando Health Sleep Lab
- Physiological Laboratory
- Zephyrhills, FL
- NPI 1679344394
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba St. Joseph's Women's Hospital
- General Acute Care Hospital
- Tampa, FL
- NPI 1346519816
-
dba St. Joseph's Hospital
- General Acute Care Hospital
- Tampa, FL
- NPI 1881632818
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733961600000",
"number": "1609429406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38135 MARKET SQUARE DR",
"city": "ZEPHYRHILLS",
"state": "FL",
"postal_code": "335427505",
"telephone_number": "352-567-0188",
"fax_number": "813-355-5101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1721 BRANDON MAIN ST STE D",
"city": "BRANDON",
"state": "FL",
"postal_code": "335115018",
"telephone_number": "813-977-2020",
"fax_number": "813-355-5010"
}
],
"practiceLocations": [
{
"address_1": "450 Clarkson Ave",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "112032012",
"country_code": "US",
"telephone_number": "917-701-3133",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Brookdale Plz",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "112123139",
"country_code": "US",
"telephone_number": "718-240-7630",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ADENIRAN",
"first_name": "OMOLARA",
"middle_name": "GRACE",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-07-20",
"last_updated": "2024-12-12",
"certification_date": "2024-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "445764",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RE0101X",
"taxonomy_group": "",
"desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
"state": "FL",
"license": "ME1683456",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brandon, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.