Individual provider Active NPI

Aishat Omoyeni Olagunju, MD

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1912427410
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD2019-1104 Issued in NM
Practice address
4422 3Rd Avenue
St Barnabas Hospital
Bronx, NY 10468-4709
Phone
(832) 417-6927
NPI assigned
Jun 26, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X MD2019-1104 NM Primary

Addresses

Primary practice location

4422 3Rd Avenue
St Barnabas Hospital
Bronx, NY 10468-4709

Mailing address

4422 3Rd Ave Dept of
Bronx, NY 10457-2545
Phone (718) 960-6202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20220407000779 GA Practitioner - HospitalistPractitioner - Internal Medicine 5193141323 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Group practices
Apogee Medical Group GeorgiaGroup PAC ID 4587676945, 122 clinicians

Practice addresses (Care Compare)

2501 N Patterson St
Valdosta, GA 31602-1735
Phone (229) 333-1000

Hospital & facility affiliations

  • SGMC Health Hospital, Valdosta, GA, CCN 110122
  • SGMC Health Lanier Hospital, Lakeland, GA, CCN 111326
  • Clinch Memorial Hospital Hospital, Homerville, GA, CCN 111308

Merit-based Incentive Payment System (MIPS)

Final score
87.29 of 100Reported as group
Quality
70.79
Improvement activities
40
Cost
81.32

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2019-1104NMMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group Georgia Internal Medicine CurrentSince Mar 1, 2022 Accepting new patients

Locations

15059 N Scottsdale Rd
Ste 600
Scottsdale, AZ 85254
Phone (602) 778-3601

705 Dixie St
Carrollton, GA 30117
Phone (770) 812-9666

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

Interoperability endpoints

  • Direct secure messaging: aishat.olagunju.1@18107.direct.athenahealth.com

Organizations & group practices 1

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 3

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": "1498435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1912427410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4422 3RD AVE DEPT OF",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104572545",
            "telephone_number": "718-960-6202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4422 3RD AVENUE",
            "address_2": "ST BARNABAS HOSPITAL",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104684709",
            "telephone_number": "832-417-6927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLAGUNJU",
        "first_name": "AISHAT",
        "middle_name": "OMOYENI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-26",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "MD2019-1104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.