Individual provider Active NPI

Adenike Mojisola Moore, D.O.

  • Psychiatry Physician
  • Cincinnati, OH
National Provider Identifier
1699794396
Registry record updated Oct 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
PENDING Issued in OH
Practice address
1101 Summit Rd
Cincinnati, OH 45237-2621
Phone
(513) 948-3600
Fax
(513) 948-8631
NPI assigned
Jul 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X PENDING OH Primary

Addresses

Primary practice location

1101 Summit Rd
Cincinnati, OH 45237-2621

Mailing address

1101 Summit Rd
Cincinnati, OH 45237-2621
Phone (513) 948-3600

Other names 1

  • Ms. Adenike Mojisola Long Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20061011000051 OH Practitioner - Psychiatry 1052317203 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Ohio University, College of Osteopathic Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1101 Summit Rd
Cincinnati, OH 45237-2621
Phone (513) 948-3600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PENDINGOHMDVascular Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Ohio Office of Budget and Management State Accounting CurrentSince Sep 21, 2015 Accepting new patients
State of Ohio Office of Budget and Management State Accounting CurrentSince Sep 21, 2015 Accepting new patients

Locations

1101 Summit Rd
Cincinnati, OH 45237
Phone (513) 948-3600

30 E Broad St
Fl 11
Columbus, OH 43215
Phone (614) 466-9930

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443657600000",
    "number": "1699794396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 SUMMIT RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452372621",
            "telephone_number": "513-948-3600",
            "fax_number": "513-948-8631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 SUMMIT RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452372621",
            "telephone_number": "513-948-3600",
            "fax_number": "513-948-8631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ADENIKE",
        "middle_name": "MOJISOLA",
        "name_prefix": "Mrs.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2015-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADENIKE",
            "last_name": "LONG",
            "middle_name": "MOJISOLA",
            "prefix": "MS.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.