James Olushola Abanishe, M.D
Individual provider Active NPI Psychiatry Physician · New New, NY
NPI 1992053573 · NPPES record last updated Jan 11, 2016
Key facts
- NPI
- 1992053573
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 50979 (AZ)
- Practice address
- 506 Lenox Avenue
New New, NY 10037 - Phone
- (212) 939-1000
- NPI assigned
- Aug 29, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Psychiatry
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2292 W Magee Rd
Suite 290
Tucson, AZ 85742-4306
Phone (520) 505-4653
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150902000156 | AZ | Practitioner - Psychiatry | 1052627387 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50979 | AZ | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Allied Physicians LLC | Current |
Accepting new patients | |
| Sonora Behavioral Health Hospital, LLC | Current |
Accepting new patients | |
| Mountain Dew Behavioral Health PLC | Current |
Accepting new patients | |
| Northwest Allied Physicians, LLC | Current |
Accepting new patients | |
| Sonora Behavioral Health Hospital, LLC | Current |
Accepting new patients |
Locations
1551 E Tangerine Rd
Oro Valley, AZ 85755
Phone (520) 901-3500
6050 N Corona Rd
Tucson, AZ 85704
Phone (520) 469-8700
8333 N Silverbell Rd
Ste 161
Tucson, AZ 85743
Phone (520) 202-7770
2292 W Magee Rd
Ste 290
Tucson, AZ 85742
Phone (520) 505-4653
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Psychiatry Physician | 2084P0800X | 50979 | AZ | Yes |
Addresses
Primary practice location
506 Lenox Avenue
New New, NY 10037
Mailing address
1551 E Tangerine Rd
Oro Valley, AZ 85755-6213
Phone (917) 376-7701
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 11, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.