Olaseni Ajibade, M.D.
Individual provider Active NPI Internal Medicine Physician · Lithonia, GA
NPI 1629327598 · NPPES record last updated Jan 18, 2024
Key facts
- NPI
- 1629327598
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 86155 (GA)
- Practice address
- 2801 Dekalb Medical Pkwy
Lithonia, GA 30058-4996 - Phone
- (404) 501-8000
- NPI assigned
- Sep 6, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Mercer University School of Medicine, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Emory Specialty Associates, LLC
Hospital Physician Services - Southeast Professional Corporation
Practice addresses (Care Compare)
1821 Clifton Rd NE
Atlanta, GA 30329-4021
Phone (404) 728-6812
3651 Wheeler Rd
Augusta, GA 30909-6521
Phone (706) 651-3232
550 Peachtree St NE
Atlanta, GA 30308-2247
Phone (404) 847-0893
Hospital & facility affiliations
- Emory Hillandale Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.51 of 100
- Quality
- 80.61
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200902001714 | GA | Practitioner - Internal Medicine |
7012201148 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emory Specialty Associates, LLC | Internal Medicine | Current |
Accepting new patients |
| Hospital Physician Services - Southeast Professional Corporation | Hospitalist | Current |
Accepting new patients |
| Unlv Medicine | Internal Medicine | Past | Accepting new patients |
| Dekalb Medical Center, Inc. | Past | Accepting new patients |
Locations
2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193
1821 Clifton Rd NE
Atlanta, GA 30329
Phone (404) 728-6812
3651 Wheeler Rd
Augusta, GA 30909
Phone (706) 651-3232
501 Redmond Rd NW
Rome, GA 30165
Phone (706) 291-0291
2801 DeKalb Medical Pkwy
Stonecrest, GA 30058
Phone (404) 501-5374
Interoperability endpoints
- oajibade847838@direct.emory.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 86155 | GA | Yes |
| Hospitalist Physician | 208M00000X | 86155 | GA |
Addresses
Primary practice location
2801 Dekalb Medical Pkwy
Lithonia, GA 30058-4996
Mailing address
3651 Wheeler Rd
Augusta, GA 30909-6426
Other practice location 1
3651 Wheeler Rd
Augusta, GA 30909-6426
Phone (706) 651-3232
Other providers in Lithonia, GA
- Joy Agboola
- Ageless Health Care & Assisted Living
- AIDS Healthcare Foundation
- AIDS Healthcare Foundation
- Cyriacus Chinedu Ajaelu
- Natalie Akerele
- Akinson Residential and Community Healthcare Services Inc
- Michelle Alade
- Rita Alema-Mensah
- Judith Paula Alexander
All providers in Lithonia, GA · Internal Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.