Victoria Adewunmi

Individual provider Active NPI Emergency Medicine Physician · Bronx, NY

NPI 1891989604 · NPPES record last updated Sep 5, 2007

Key facts

NPI
1891989604
Entity type
Individual (NPI type 1)
Primary specialty
Emergency Medicine Physician 207P00000X
License
60-245887 (NY)
Practice address
111 E 210TH St
Bronx, NY 10467-2401
Phone
(718) 920-6626
NPI assigned
Sep 5, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 17

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.

Hospital & facility affiliations 1

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

Medicare Care Compare profile

Specialty
Emergency Medicine
Education
State University of Ny Upstate Medical University, 2003
Medicare assignment
May accept Medicare assignment
Group practices
Montefiore Medical Center (2,809 clinicians)

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

Hospital & facility affiliations

  • Montefiore Medical Center Hospital · Bronx, NY · CCN 330059

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100 (group)
Promoting interoperability
100
Improvement activities
40

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20071011000501 NY Practitioner - Emergency Medicine 8729174495 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
60-245887NYMDEmergency Medicine Physician

Practice roles (2 of 6)

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center Emergency Medicine Current
since Oct 10, 2007
Accepting new patients
Montefiore Medical Center Current
since Oct 10, 2007
Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

1825 Eastchester Rd
Bronx, NY 10461
Phone (718) 904-2000

Networks

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

Interoperability endpoints

  • Direct secure messaging: vicogung@montefioredirect.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 60-245887 NY Yes

Addresses

Primary practice location

111 E 210TH St
Bronx, NY 10467-2401

Mailing address

111 E 210TH St
Bronx, NY 10467-2401
Phone (718) 920-6626

Other providers in Bronx, NY

All providers in Bronx, NY · Emergency Medicine Physician in New York

Sources for this page

Verify at the official NPI Registry.