Oluwafisayo Adekoya, MD
Individual provider Active NPI General Practice Physician · Albany, NY
NPI 1700317005 · NPPES record last updated Aug 16, 2021
Key facts
- NPI
- 1700317005
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 306495 (NY)
- Practice address
- 47 New Scotland Ave
Department of Surgery
Albany, NY 12208-3412 - Phone
- (518) 262-5374
- NPI assigned
- Mar 27, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- General Practice
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Medical Director Services PC
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
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- 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 |
|---|---|---|---|---|
| I20260611002149 | NY | Practitioner - General Practice | 7113264607 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63830 | NY | MD | Student in an Organized Health Care Education/Training Program |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 63830 | NY | |
| General Practice Physician | 208D00000X | 306495 | NY | Yes |
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
Other providers in Albany, NY
- Wendy E Adams
- Linda Rose Addario
- Elizabeth Addeo
- Sidharth Addepalli
- Latoya Denim Addison
- Evan Adelstein
- Folasade Funmilayo Adelugba
- Folafoluwa Adesina
- Angela Adger
- Khaled Adil
All providers in Albany, NY · General Practice Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 16, 2021. 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.