Ayodeji Adetayo Ayeni, M.D

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A85436 Issued in CA

Practice address

501 Munzer St Ste C
Shafter, CA 93263-2042

Phone

(661) 630-5274

Fax

(661) 630-5290

NPI assigned

Jun 20, 2005

Last updated

Oct 3, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Pediatric Medicine

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shafter Urgent CareGroup PAC ID 9133494578, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Shafter Pediatrics

  • Pediatrics Physician
  • Shafter, CA
  • NPI 1811362908

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, W-2 Managing Employee

  CMS ownership
• Shafter Pediatrics

  dba Elmo pediatrics & family walk-in clinic

  • Clinic/Center
  • Shafter, CA
  • NPI 1821763590

  5% Or Greater Direct Ownership Interest

  CMS ownership
• Shafter Urgent Care

  • Urgent Care Clinic/Center
  • Shafter, CA
  • NPI 1376994533

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer

  CMS ownership

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.

• Shafter Pediatrics

  • Pediatrics Physician
  • Shafter, CA
  • NPI 1811362908
  Medicare reassignment NPD Authorized official
• Shafter Urgent Care

  • Urgent Care Clinic/Center
  • Shafter, CA
  • NPI 1376994533
  Medicare reassignment Care Compare group NPD
• Shafter Pediatrics

  dba Elmo pediatrics & family walk-in clinic

  • Clinic/Center
  • Shafter, CA
  • NPI 1821763590

  Pediatrics

  NPD Authorized official
• Bakersfield Memorial Hospital

  dba Bakersfield Memorial Hospital Pharmacy

  • Institutional Pharmacy
  • Bakersfield, CA
  • NPI 1144256363
  NPD (past)
• Dignity Health

  dba Mercy Hospital

  • General Acute Care Hospital
  • Bakersfield, CA
  • NPI 1104981661
  NPD (past)
• Omni Family Health

  • Federally Qualified Health Center (FQHC)
  • Delano, CA
  • NPI 1417962457
  NPD (past)
• Omni Family Health

  • Federally Qualified Health Center (FQHC)
  • Tehachapi, CA
  • NPI 1851325021
  NPD (past)
• San Joaquin Community Hospital

  • General Acute Care Hospital
  • Bakersfield, CA
  • NPI 1538157508
  NPD (past)

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475452800000",
    "number": "1831194331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22694",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933902694",
            "telephone_number": "661-364-5244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 MUNZER ST STE C",
            "city": "SHAFTER",
            "state": "CA",
            "postal_code": "932632042",
            "telephone_number": "661-630-5274",
            "fax_number": "661-630-5290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYENI",
        "first_name": "AYODEJI",
        "middle_name": "ADETAYO",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2016-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A85436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Alford, IDMT
• Nathan Carl Allen, P.A.
• Art of Serenity Inc (Sandra Demmin Wellness Center)
• Av Elite Medical LLC
• Aviation Medi Group Inc
• Shike Ayeni, FNP-C
• Mario Bagallon, RADIOLOGY TECH
• Amanda Bilik
• Brighter Day Strtp
• Brighter Days Ahead LLC (Brighter Day)

• Pediatrics Physician in Shafter, CA
• Providers in Shafter, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.