Anna Ejuile Adekugbe, M.D

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

01072692A Issued in IN

Practice address

8933 White Oak Ave
Munster, IN 46321-3134

Phone

(219) 838-7703

NPI assigned

Jun 9, 2011

Sex

Female

Sole proprietor

Yes

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.

• Beacon Behavioral Pediatric Clinic LLC

  • Primary Care Clinic/Center
  • Munster, IN
  • NPI 1497453252
  NPD Authorized official
• All Smiles Munster

  • Dental Clinic/Center
  • Munster, IN
  • NPI 1457917163
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 21, 2023.

{
    "created_epoch": "1307577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1982999751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1137 TREADWAY RD",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212856",
            "telephone_number": "617-308-1720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8933 WHITE OAK AVE",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463213134",
            "telephone_number": "219-838-7703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEKUGBE",
        "first_name": "ANNA",
        "middle_name": "EJUILE",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-09",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01072692A",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125057555",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201190960",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ted George Ody Achufusi Jr., MD
• Suzanna Elena Acosta, OD
• Active Day in, Inc.
• Sara B. Adams
• Vijay Krishna Adavelly, P.T.
• John M Adlard, MD
• Jacquelyn Raquel Adley, NP-C
• Adult and Pediatric Eye Specialists Corp
• Advanced Care Medical Specialists, P.C.
• Advanced Health Services, Inc.

• All providers in Munster, IN
• Pediatrics Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.