NPIMap

Individual provider Active NPI

Oritsegbubemi Eghosa Adekola, MD

  • Nephrology Physician
  • Detroit, MI
National Provider Identifier
1992074298
Registry record updated Aug 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
4301101063 Issued in MI
Practice address
4160 John R St Ste 917
Detroit, MI 48201-2017
Phone
(313) 745-4525
Fax
(313) 745-0011
NPI assigned
Dec 15, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301101063 MI
Hospitalist Physician 208M00000X 4301101063 MI
Nephrology Physician 207RN0300X 4301101063 MI Primary

Addresses

Primary practice location

4160 John R St Ste 917
Detroit, MI 48201-2017

Mailing address

1560 E Maple Road
Ste 400-Credentialing
Troy, MI 48083-1135
Phone (313) 745-4525

Other names 1

  • Dr. Oritsegbubemi Eghosa Olupitan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191024000420 IL Practitioner - Nephrology 4688822349 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Siu Physicians and Surgeons IncGroup PAC ID 2365352820, 316 clinicians

Practice addresses (Care Compare)

751 N Rutledge St
Springfield, IL 62702-4968
Phone (217) 545-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
21.77 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
72.58

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Siu Physicians & Surgeons, Inc Internal Medicine CurrentSince Sep 15, 2019 Accepting new patients
Central Illinois Kidney & Dialysis Associates, SC Nephrology CurrentSince Jan 26, 2020 Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince Sep 15, 2019 Accepting new patients
Siu Physicians & Surgeons, Inc Past Accepting new patients

Locations

1215 Franciscan Dr
Litchfield, IL 62056
Phone (217) 324-2191

3401 Conifer Dr
Springfield, IL 62711
Phone (217) 726-0967

751 N Rutledge St
Ste 1100
Springfield, IL 62702
Phone (217) 545-0182

751 N Rutledge St
Springfield, IL 62702
Phone (217) 545-0182

Interoperability endpoints

  • Direct secure messaging: oadekola261534@ewd.direct.hshs.org

Organizations & group practices 4

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.

Hospital & facility affiliations 10

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": "1323907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503964800000",
    "number": "1992074298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 E MAPLE ROAD",
            "address_2": "STE 400-CREDENTIALING",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831135",
            "telephone_number": "313-745-4525",
            "fax_number": "313-745-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 JOHN R ST STE 917",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012017",
            "telephone_number": "313-745-4525",
            "fax_number": "313-745-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEKOLA",
        "first_name": "ORITSEGBUBEMI",
        "middle_name": "EGHOSA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-15",
        "last_updated": "2017-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301101063",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MI",
            "license": "4301101063",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MI",
            "license": "4301101063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ORITSEGBUBEMI",
            "last_name": "OLUPITAN",
            "middle_name": "EGHOSA",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.