Individual provider Active NPI

Adebayo Olufemi Atolagbe, M.D.

  • Pediatrics Physician
  • Phoenix, AZ
National Provider Identifier
1891962056
Registry record updated May 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
43176 Issued in AZ
Practice address
2510 W Dunlap Ave
Suite 290
Phoenix, AZ 85021-2737
Phone
(602) 789-0344
Fax
(602) 789-8279
NPI assigned
May 15, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 43176 AZ Primary
Pediatrics Physician 208000000X P2823 TX

Addresses

Primary practice location

2510 W Dunlap Ave
Suite 290
Phoenix, AZ 85021-2737

Mailing address

2510 W Dunlap Ave
Suite 290
Phoenix, AZ 85021-2737
Phone (602) 789-0344

Other identifiers 1

IdentifierTypeStateIssuer
569079MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20101211000125 AZ Practitioner - Pediatric Medicine 5890982110 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43176AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Physician Super Specialists Arizona LLC Current Accepting new patients
Phoenix Children'S Medical Group CurrentSince Jan 1, 2021 Accepting new patients
Phoenix Children'S Medical Group CurrentSince Jan 1, 2021 Accepting new patients
Arizona Acute Medical Services 1 PC Hospitalist CurrentSince Apr 1, 2017 Accepting new patients
Phoenix Children'S Hospital Pediatrics Current Accepting new patients
Starlight Pediatric Primary Care PLLC Pediatrics CurrentSince Aug 11, 2019 Accepting new patients
Banner Physician Super Specialists Arizona LLC CurrentSince Jan 1, 2018 Accepting new patients
Banner Physician Super Specialists Arizona LLC CurrentSince Jan 1, 2018 Accepting new patients
Renue Psychiatry PLLC PastSince Dec 31, 2023 Accepting new patients
Dignity Health Past Accepting new patients
Arizona Post-Acute Medical Services 1 PC Hospitalist Past Accepting new patients
Banner Ironwood Medical Center Past Accepting new patients
Starlight Pediatrics Urgent Care, PLLC Past Accepting new patients
VHS Outpatient Clinics, Inc. Past Accepting new patients
Zion Medical Group PLLC Hospitalist Past Accepting new patients

Locations

1215 N Ivy Loop
Ste 101
Casa Grande, AZ 85122
Phone (480) 544-4400

1215 N Ivy Loop
Casa Grande, AZ 85122
Phone (347) 791-5827

1452 N Higley Rd
Gilbert, AZ 85234
Phone (480) 813-9600

3507 S Mercy Rd
Ste 103
Gilbert, AZ 85297
Phone (480) 355-8530

1900 N Higley Rd
Gilbert, AZ 85234
Phone (480) 543-2000

5555 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 588-5555

1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000

1432 S Dobson Rd
Ste 301
Mesa, AZ 85202
Phone (480) 412-7120

5750 E Baseline Rd
Mesa, AZ 85206
Phone (602) 246-5797

2510 W Dunlap Ave
Ste 290
Phoenix, AZ 85021

3929 E Bell Rd
Phoenix, AZ 85032
Phone (602) 923-5000

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

9003 E Shea Blvd
Scottsdale, AZ 85260
Phone (480) 323-3383

1921 W Hospital Dr
Tucson, AZ 85704
Phone (520) 544-5200

265 Brookview Centre Way
Ste 400
Knoxville, TN 37919
Phone (865) 293-5549

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17364/brand/1/csg/1/fhir/r4
  • Direct secure messaging: adebayo.atolagbe.1@17364.direct.athenahealth.com

Organizations & group practices 15

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494547200000",
    "number": "1891962056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 W DUNLAP AVE",
            "address_2": "SUITE 290",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850212737",
            "telephone_number": "602-789-0344",
            "fax_number": "602-789-8279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 W DUNLAP AVE",
            "address_2": "SUITE 290",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850212737",
            "telephone_number": "602-789-0344",
            "fax_number": "602-789-8279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATOLAGBE",
        "first_name": "ADEBAYO",
        "middle_name": "OLUFEMI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-15",
        "last_updated": "2017-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "43176",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P2823",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "569079",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.