Individual provider Active NPI

Adesoji E Oderinde, MD

  • Internal Medicine Physician
  • Atlanta, GA
National Provider Identifier
1972503860
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
048285 Issued in GA
Practice address
80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031
Phone
(404) 616-1000
NPI assigned
Jul 21, 2005
Last updated
Aug 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 048285 GA Primary

Addresses

Primary practice location

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

Mailing address

720 Westview Drive SW
Harris BLDG., 100-a
Atlanta, GA 30310
Phone (404) 756-1400

Other practice location 1

1800 Howell Mill Rd NW Ste 275
Atlanta, GA 30318-3098
Phone (404) 756-1290

Other identifiers 1

IdentifierTypeStateIssuer
000878919BMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aoderinde10015@direct.gmh.edu Direct

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
I20050720000371 GA Practitioner - Internal Medicine 1951338110 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Morehouse Healthcare, Inc.Group PAC ID 6002701273, 155 clinicians

Practice addresses (Care Compare)

80 Jesse Hill Jr Dr NE
Atlanta, GA 30303-2613
Phone (404) 756-1410

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
048285GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Independence Emergency Physicians LLC CurrentSince Feb 1, 2005 Accepting new patients
Morehouse Healthcare, Inc. Internal Medicine CurrentSince Jan 1, 2001 Accepting new patients
Chatuge Regional Hospital Inc Internal Medicine Past Accepting new patients
Wellstar Medical Group, LLC PastSince Jan 1, 2001 Accepting new patients
Chatuge Regional Hospital Inc Past Accepting new patients
Grady Memorial Hospital Corporation Past Accepting new patients

Locations

1800 Howell Mill Rd NW
Ste 275
Atlanta, GA 30318
Phone (404) 287-0054

720 Westview Dr SW
Bldg 100A
Atlanta, GA 30310

720 Westview Dr SW
Ste 100A
Atlanta, GA 30310

75 Piedmont Ave NE
Ste 700
Atlanta, GA 30303
Phone (404) 756-1410

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

200 Allen Memorial Dr
Bremen, GA 30110
Phone (770) 537-5851

1595 Cleveland Ave
East Point, GA 30344
Phone (404) 305-8086

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1972503860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 WESTVIEW DRIVE SW",
            "address_2": "HARRIS BLDG., 100-A",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30310",
            "telephone_number": "404-756-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 JESSE HILL JR DR SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033031",
            "telephone_number": "404-616-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Howell Mill Rd NW Ste 275",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303183098",
            "country_code": "US",
            "telephone_number": "404-756-1290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODERINDE",
        "first_name": "ADESOJI",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "048285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000878919B",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aoderinde10015@direct.gmh.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "80 Jesse Hill Jr Dr SE",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303033031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.