Individual provider Active NPI

Oluwafisayo Adekoya, MD

  • General Practice Physician
  • Albany, NY
National Provider Identifier
1700317005
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
306495 Issued in NY
Practice address
47 New Scotland Ave
Department of Surgery
Albany, NY 12208-3412
Phone
(518) 262-5374
NPI assigned
Mar 27, 2017
Last updated
Aug 16, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 63830 NY
General Practice Physician 208D00000X 306495 NY Primary

Addresses

Primary practice location

47 New Scotland Ave
Department of Surgery
Albany, NY 12208-3412

Mailing address

101 Elkin CT Dept of
Delmar, NY 12054-9635
Phone (443) 204-1941

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20260611002149 NY Practitioner - General Practice 7113264607 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Director Services PCGroup PAC ID 0042501116, 79 clinicians

Practice addresses (Care Compare)

49 Marvin Ave
Troy, NY 12180-6425
Phone (718) 731-9700

50 Sheffield Ave
Brooklyn, NY 11207-2420
Phone (718) 345-2273

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
306495NYMDGeneral Practice Physician
63830NYMDStudent in an Organized Health Care Education/Training Program

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1700317005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 ELKIN CT DEPT OF",
            "city": "DELMAR",
            "state": "NY",
            "postal_code": "120549635",
            "telephone_number": "443-204-1941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 NEW SCOTLAND AVE",
            "address_2": "DEPARTMENT OF SURGERY",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083412",
            "telephone_number": "518-262-5374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEKOYA",
        "first_name": "OLUWAFISAYO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-27",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "63830",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "306495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.