NPIMap

Individual provider Active NPI

Simbo Oluwabusuyi Aduloju, M.D

  • Hematology & Oncology Physician
  • Decatur, GA
National Provider Identifier
1770769234
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
056674 Issued in GA
Practice address
2712 Lawrenceville Hwy
Decatur, GA 30033-2512
Phone
(770) 496-5555
Fax
(770) 939-2887
NPI assigned
Jan 15, 2008
Last updated
Aug 25, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 056674 GA Primary

Addresses

Primary practice location

2712 Lawrenceville Hwy
Decatur, GA 30033-2512

Mailing address

1835 Savoy Dr
Suite 300
Atlanta, GA 30341-1072
Phone (770) 496-5555

Other identifiers 3

IdentifierTypeStateIssuer
601834418DMedicaidGA
202I832053OtherGAMEDICARE PTAN
601834418A-CMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address simbo.adulojumd.p1@direct.gacancer.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090730000383 GA Practitioner - Hematology/OncologyPractitioner - Internal Medicine 8022161587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
New York University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2712 Lawrenceville Hwy
Decatur, GA 30033-2512
Phone (770) 496-5555

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
71.19 of 100Reported as group
Quality
69.24
Improvement activities
40
Cost
51.37

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
NSH Cancer Institute Professional Services G, LLC Hematology & Oncology CurrentSince Jan 1, 2013 Accepting new patients
NSH Cancer Institute Professional Services G, LLC Hematology & Oncology Current Accepting new patients
NSH Cancer Institute Professional Services G LLC CurrentSince Jan 1, 2013 Accepting new patients
Northside Imaging LLC Past Accepting new patients

Locations

1835 Savoy Dr
Ste 300
Atlanta, GA 30341
Phone (678) 288-9555

2712 Lawrenceville Hwy
Decatur, GA 30033
Phone (770) 496-5555

620 J L White Dr
Ste 140
Jasper, GA 30143
Phone (706) 253-3500

6300 Hospital Pkwy
Ste 300
Johns Creek, GA 30097
Phone (770) 623-8965

5700 Hillandale Dr
Ste 250
Lithonia, GA 30058
Phone (770) 981-5431

1045 Southcrest Dr
Ste 200
Stockbridge, GA 30281
Phone (678) 289-0549

Interoperability endpoints

  • Direct secure messaging: simbo.adulojumd.p1@direct.gacancer.nextgenshare.com

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1200355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1770769234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 SAVOY DR",
            "address_2": "SUITE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303411072",
            "telephone_number": "770-496-5555",
            "fax_number": "770-939-2887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2712 LAWRENCEVILLE HWY",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300332512",
            "telephone_number": "770-496-5555",
            "fax_number": "770-939-2887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADULOJU",
        "first_name": "SIMBO",
        "middle_name": "OLUWABUSUYI",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-15",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "GA",
            "license": "056674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "601834418D",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "202I832053",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "601834418A-C",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "simbo.adulojumd.p1@direct.gacancer.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "2712 Lawrenceville Hwy",
            "city": "Decatur",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300332512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.