Adeyinka Adebayo Agbetoyin, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

36918 Issued in TN

Practice address

2968 North Highland Ave
Jackson, TN 38305

Phone

(731) 256-1819

Fax

(731) 664-4330

NPI assigned

Jun 6, 2006

Sex

Male

Sole proprietor

No

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.

• Cardiovascular Clinic of West TN PC

  • Cardiovascular Disease Physician
  • Jackson, TN
  • NPI 1740480961

  Cardiovascular Disease, TN

  Medicare reassignment Care Compare group NPD Authorized official
• The Cardiovascular Clinic of West Tennessee,P.C.

  • Cardiovascular Disease Physician
  • Jackson, TN
  • NPI 1013112457

  Cardiovascular Disease

  NPD Authorized official
• Mid - South Heart Center PC

  • Specialist
  • Jackson, TN
  • NPI 1215982681
  NPD (past)

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

• Baptist Memorial Hospital-Huntingdon

  • General Acute Care Hospital
  • Huntingdon, TN
  • NPI 1710941356

  Hospital

  Care Compare affiliation
• Camden General Hospital, Inc.

  • Critical Access Hospital
  • Camden, TN
  • NPI 1659347920

  Hospital

  Care Compare affiliation
• Jackson Madison County General Hospital

  • General Acute Care Hospital
  • Jackson, TN
  • NPI 1093705428

  Hospital

  Care Compare affiliation
• Martin Health

  • General Acute Care Hospital
  • Martin, TN
  • NPI 1275505372

  Hospital

  Care Compare affiliation
• Milan General Hospital, Inc.

  • General Acute Care Hospital
  • Milan, TN
  • NPI 1699765453

  Hospital

  Care Compare affiliation

Specialty

Cardiovascular Disease (Cardiology)Also: Peripheral Vascular Disease

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cardiovascular Clinic of West TN PC 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jackson-Madison County General Hospital Hospital, Jackson, TN, CCN 440002
• West Tennessee Healthcare Milan Hospital Hospital, Milan, TN, CCN 440060
• Baptist Memorial Hospital - Carroll County Hospital, Huntingdon, TN, CCN 440016
• West Tennessee Healthcare Camden Hospital Hospital, Camden, TN, CCN 441316
• Volunteer Community Hospital Hospital, Martin, TN, CCN 440061

Procedures performed for Medicare patients

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DAGDAA
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: aagbetoy@yourcarecommunity.org

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

Specialties & licenses 1

Addresses

Other identifiers 5

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714262400000",
    "number": "1922047422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2968 NORTH HIGHLAND AVENUE",
            "address_2": "SUITE A",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053609",
            "telephone_number": "731-256-1819",
            "fax_number": "731-664-4330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2968 NORTH HIGHLAND AVE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38305",
            "telephone_number": "731-256-1819",
            "fax_number": "731-664-4330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGBETOYIN",
        "first_name": "ADEYINKA",
        "middle_name": "ADEBAYO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2024-04-28",
        "certification_date": "2024-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TN",
            "license": "36918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7638433",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4160707",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH",
            "identifier": "87726",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00440784",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TLC",
            "identifier": "41719",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Jackson, TN
• Cardiovascular Disease Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.