Active NPI
Adjoavi Fakonam Andele, M.D.
- Obstetrics & Gynecology Physician
- Hagerstown, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- D0064550
- Practice address
- 1130 Professional CT
Hagerstown, MD 21740-5852 - Phone
- (301) 791-5555
- Fax
- (301) 791-8104
- NPI assigned
- Jun 26, 2006
- Last updated
- Dec 11, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | D0064550 | MD | Primary |
Addresses
Primary practice location
1130 Professional CT
Hagerstown, MD 21740-5852
Mailing address
11116 Medical Campus Rd
Hagerstown, MD 21742-6710
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D0064550 | Other | MD | DHMH LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- University of Louisville School of Medicine, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Meritus Medical Center Inc
Practice addresses (Care Compare)
11110 Medical Campus Rd
Hagerstown, MD 21742-6700
11110 Medical Campus Rd
Suite 107
Hagerstown, MD 21742-6734
Phone (301) 714-4100
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of the uterus | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0064550 | MD | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Practices of Antietam, LLC | Current | Accepting new patients | |
| Medical Practices of Antietam LLC | Current | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Locations
11110 Medical Campus Rd
Hagerstown, MD 21742
Phone (240) 313-9800
11110 Medical Campus Rd
Ste 107
Hagerstown, MD 21742
Phone (301) 714-4100
11110 Medical Campus Rd
Ste 229
Hagerstown, MD 21742
Phone (301) 665-4500
11110 Medical Campus Rd
Ste 249
Hagerstown, MD 21742
Phone (301) 665-9098
11116 Medical Campus Rd
Hagerstown, MD 21742
Phone (301) 766-7600
1130 Professional Ct
Hagerstown, MD 21740
Phone (301) 791-5555
3 Byrkit Dr
Williamsport, MD 21795
Phone (301) 582-1150
Organizations & group practices 3
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.
-
- Clinic/Center
- Hagerstown, MD
- NPI 1710854963
-
- General Practice Physician
- Hagerstown, MD
- NPI 1558430843
-
dba Frederick Health Hospital
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Hagerstown, MD
- NPI 1942281266
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576022400000",
"number": "1972530202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11116 MEDICAL CAMPUS RD",
"city": "HAGERSTOWN",
"state": "MD",
"postal_code": "217426710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1130 PROFESSIONAL CT",
"city": "HAGERSTOWN",
"state": "MD",
"postal_code": "217405852",
"telephone_number": "301-791-5555",
"fax_number": "301-791-8104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDELE",
"first_name": "ADJOAVI",
"middle_name": "FAKONAM",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-26",
"last_updated": "2019-12-11",
"certification_date": "2019-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "MD",
"license": "D0064550",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DHMH LICENSE",
"identifier": "D0064550",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hagerstown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; 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.