Individual provider Active NPI

Adekunbi Abosede Adelakun, M.D.

  • Pediatrics Physician
  • Southfield, MI
National Provider Identifier
1801240445
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301500526 Issued in MI
Practice address
29255 Northwestern Hwy Ste 100
Southfield, MI 48034-5740
Phone
(248) 358-2410
NPI assigned
Apr 20, 2016
Last updated
Nov 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Pediatrics Physician 208000000X 4301500526 MI Primary
Pediatric Allergy/Immunology Physician 2080P0201X 4301500526 MI

Addresses

Primary practice location

29255 Northwestern Hwy Ste 100
Southfield, MI 48034-5740

Mailing address

29255 Northwestern Hwy Ste 100
Southfield, MI 48034-5740
Phone (248) 358-2410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20220324001674 MI Practitioner - Pediatric Medicine 3274824578 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301500526MIMDPediatric Allergy/Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Single Specialty CurrentSince Mar 23, 2022 Accepting new patients
Henry Ford Health System Single Specialty Current Accepting new patients
Henry Ford Health System CurrentSince Mar 23, 2022 Accepting new patients
My Kids Doc-Southfield Single Specialty PastSince Jan 26, 2022 Accepting new patients

Locations

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

Interoperability endpoints

  • Direct secure messaging: aadelakun548201@direct.hfhs.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.

NPI Registry JSON

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

{
    "created_epoch": "1461110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1801240445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29255 NORTHWESTERN HWY STE 100",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480345740",
            "telephone_number": "248-358-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29255 NORTHWESTERN HWY STE 100",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480345740",
            "telephone_number": "248-358-2410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADELAKUN",
        "first_name": "ADEKUNBI",
        "middle_name": "ABOSEDE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-20",
        "last_updated": "2023-11-01",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301500526",
            "primary": true
        },
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "MI",
            "license": "4301500526",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.