Abidemi Adetoyese Adegbola, M.D

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD446583 Issued in PA

Practice address

3905 Ford Rd
Suite 6
Philadelphia, PA 19131-2824

Phone

(215) 220-2196

NPI assigned

Nov 14, 2006

Last updated

Jun 17, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, OH2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Psychiatry

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University Hospitals Medical Group IncGroup PAC ID 4789682493, 2,248 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aadegbola36174@ehrdirect.uhhospitals.org

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.

• University Hospitals Medical Group Inc

  • Multi-Specialty Clinic/Center
  • Cleveland, OH
  • NPI 1669499414

  Clinical Genetics (M.D.)

  Medicare reassignment Care Compare group NPD
• DLP Conemaugh Physician Practices LLC

  dba Conemaugh Physician Group Cresson

  • Family Medicine Physician
  • Cresson, PA
  • NPI 1932515905
  Medicare reassignment NPD
• Family Care Centers Inc.

  dba Lehigh Valley Physician Group - Pocono

  • Internal Medicine Physician
  • E Stroudsburg, PA
  • NPI 1669563037

  Psychiatry

  Medicare reassignment NPD
• DLP Conemaugh Physician Practices LLC

  • Internal Medicine Physician
  • Johnstown, PA
  • NPI 1205242609
  NPD
• DLP Conemaugh Physician Practices LLC

  dba Conemaugh Physician Group Ebensburg Industrial Park

  • Family Medicine Physician
  • Ebensburg, PA
  • NPI 1831505981
  NPD
• Physicians of Cape Cod Hospital

  • Neuroradiology Physician
  • Hyannis, MA
  • NPI 1679832364
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1669544169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 CHESTNUT ST",
            "address_2": "PH113",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075127",
            "telephone_number": "314-348-4546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3905 FORD RD",
            "address_2": "SUITE 6",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191312824",
            "telephone_number": "215-220-2196"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "206 E Brown St",
            "address_purpose": "LOCATION",
            "city": "East Stroudsburg",
            "state": "PA",
            "postal_code": "183013006",
            "country_code": "US",
            "telephone_number": "570-476-3422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADEGBOLA",
        "first_name": "ABIDEMI",
        "middle_name": "ADETOYESE",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "MA",
            "license": "227766",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NH",
            "license": "13062",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD446583",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NH",
            "license": "13062",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Editus Addy
• Ajoke Olivia Adebayo
• Oluwakemi Adedokun
• Rasidat Adeduntan, MD
• Nichelle Secorra Adegbite-Maraventano, M.D.
• Ibijoke Helen Adegboyega, CRNP
• Enitan Adegite, MD
• Tatiana Adejare, D.C.
• Olukemi A Adekanmbi, MD
• Emmanuel Ifeoluwa Adekanye

• Psychiatry Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; 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.

Verify at the official NPI Registry.