Adefisayo Oduwole, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

042381 Issued in GA

Practice address

80 Jesse Hill Jr Dr SE
Ste 2E
Atlanta, GA 30303-3031

Phone

(404) 616-4422

NPI assigned

Jul 21, 2005

Last updated

May 7, 2020By 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 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in GA2 enrollments

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 2

Specialty

Cardiovascular Disease (Cardiology)

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Morehouse Medicine Inc.Group PAC ID 3779082631, 30 clinicians

Morehouse Healthcare, Inc.Group PAC ID 6002701273, 155 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grady Memorial Hospital Hospital, Atlanta, GA, CCN 110079

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: adefisayo.oduwole.p48@direct.tenet.nextgenshare.com
• Direct secure messaging: adefisayo.oduwole.p50@direct.tenet.nextgenshare.com
• Direct secure messaging: aoduwole2946046@carolinashealthcaresystem.direct-ci.com

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.

• Morehouse Healthcare, Inc.

  • Cardiovascular Disease Physician
  • Atlanta, GA
  • NPI 1801832324

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Morehouse Medicine Inc.

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1700673571
  Medicare reassignment Care Compare group NPD
• Oduwole Organization Inc

  • Interventional Cardiology Physician
  • Fayetteville, GA
  • NPI 1659560647
  Medicare reassignment
• Atlanta Multi Specialty Group

  • Cardiovascular Disease Physician
  • Atlanta, GA
  • NPI 1144327461
  NPD (past)
• Chatuge Regional Hospital Inc

  dba Chatuge Medical Group

  • Internal Medicine Physician
  • Hiawassee, GA
  • NPI 1265811962
  NPD (past)
• Chatuge Regional Hospital Inc

  • Critical Access Hospital
  • Hiawassee, GA
  • NPI 1326028978
  NPD (past)
• Janah Enterprises Inc

  • Internal Medicine Physician
  • Lithonia, GA
  • NPI 1558551473
  NPD (past)
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD (past)

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

• Grady Memorial Hospital Corporation

  dba Grady Health Systems

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1992799050
  Care Compare affiliation

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588809600000",
    "number": "1952301830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 HIGHWAY 85 N STE 310-296",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147738",
            "telephone_number": "678-571-2956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 JESSE HILL JR DR SE",
            "address_2": "STE 2E",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033031",
            "telephone_number": "404-616-4422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODUWOLE",
        "first_name": "ADEFISAYO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "042381",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "042381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000728407C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000728417C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000728407U",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony Adetola Odubanjo, M.D.
• God-Dowell Oghenevwogaga Odukudu, M.D.
• Amudalat A Odunbaku
• Aso Odus Sr.
• Charles Odusanya
• Titilope Oduyebo, M.D., M.P.H
• Odyssey Healthcare Operating B, LP (Gentiva)
• Paige Oelke
• Anna Elizabeth Oesterle
• Carl W Oettinger, MD

• Cardiovascular Disease Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Cardiovascular Disease Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2020; 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.