NPIMap

Individual provider Active NPI

Bolanle Dada, M.D.

  • Internal Medicine Physician
  • Pottsville, PA
National Provider Identifier
1629099288
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD429512 Issued in PA
Practice address
700 E Norwegian St
Pottsville, PA 17901-2710
Phone
(610) 261-0270
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD429512 PA Primary

Addresses

Primary practice location

700 E Norwegian St
Pottsville, PA 17901-2710

Mailing address

118 Jeffrey LN
Northampton, PA 18067-1068
Phone (610) 261-0270

Other names 1

  • Bolanle Oludemi Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061204000043 PA Practitioner - Internal Medicine 9931108834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Physician Group Inc 2,161 clinicians

Practice addresses (Care Compare)

1021 Park Ave
Quakertown, PA 18951-0130
Phone (215) 538-4500

Hospital & facility affiliations

  • St Luke'S Home Health Home health agency, Bethlehem, PA, CCN 397002
  • St Lukes Hospital Hospital, Bethlehem, PA, CCN 390049
  • St Luke'S Hospital - Easton Campus Hospital, Easton, PA, CCN 390162

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD429512PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Physician Group Inc CurrentSince Nov 1, 2014 Accepting new patients
St. Luke'S Physician Group, Inc. Current Accepting new patients
St Luke'S Physician Group Inc CurrentSince Nov 1, 2014 Accepting new patients
St. Luke'S Hospital- Easton Campus Past Accepting new patients
St. Luke'S Physician Group, Inc Past Accepting new patients
Incare LLC Internal Medicine Past Accepting new patients
St Luke'S Hospital Past Accepting new patients
St Lukes Hospital-Anderson Campus Past Accepting new patients

Locations

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

100 Paramount Blvd
Orwigsburg, PA 17961
Phone (272) 639-1000

Organizations & group practices 8

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.

Hospital & facility affiliations 8

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629099288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 JEFFREY LN",
            "city": "NORTHAMPTON",
            "state": "PA",
            "postal_code": "180671068",
            "telephone_number": "610-261-0270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E NORWEGIAN ST",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179012710",
            "telephone_number": "610-261-0270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DADA",
        "first_name": "BOLANLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD429512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BOLANLE",
            "last_name": "OLUDEMI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pottsville, PA

Sources for this page

Verify at the official NPI Registry.