Individual provider Active NPI

Adebowale J Adeniran, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • New York, NY
National Provider Identifier
1780857672
Registry record updated Apr 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
235182 Issued in MA
Practice address
1275 York Ave
New York, NY 10065-6007
Phone
(212) 639-3292
NPI assigned
Apr 11, 2008
Last updated
Apr 11, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 235182 MA Primary

Addresses

Primary practice location

1275 York Ave
New York, NY 10065-6007

Mailing address

401 E 89TH St
Apt. # 3G
New York, NY 10128-6763
Phone (212) 639-3292

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NY2 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

Enrollment IDStateProvider typePAC IDDetails
I20090127000002 CT Practitioner - Pathology 5193889780 Reassigns benefits to 1 organization
I20250512001973 NY Practitioner - Pathology 5193889780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

1450 Chapel St B
New Haven, CT 06511-4405
Phone 20386754204405

20 York St
New Haven, CT 06510-3220
Phone (203) 688-4242

800 Howard Ave
New Haven, CT 06519-1369
Phone (203) 785-2140

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
235182MAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Dec 17, 2008 Accepting new patients
Premier Medical Group of the Hudson Valley P.C. CurrentSince May 1, 2025 Accepting new patients
Premier Medical Group of the Hudson Valley, P.C. CurrentSince May 1, 2025 Accepting new patients
Yale University CurrentSince Dec 17, 2008 Accepting new patients

Locations

300 Seaside Ave
Milford, CT 06460
Phone (203) 876-4000

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

243 North Rd
Ste 304
Poughkeepsie, NY 12601
Phone (845) 451-7251

50 Eastdale Ave N
Poughkeepsie, NY 12603
Phone (845) 437-5000

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: aadeniran@premiermedicalhv.medentdirect.com
  • Direct secure messaging: aadeniran8963@direct.ynhh.org

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": "1207872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207872000000",
    "number": "1780857672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E 89TH ST",
            "address_2": "APT. # 3G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101286763",
            "telephone_number": "212-639-3292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "212-639-3292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADENIRAN",
        "first_name": "ADEBOWALE",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-11",
        "last_updated": "2008-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MA",
            "license": "235182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.