CMS-1500 Box 24J / 33a • NPI
1669544169
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
2084P0800X (CMS 26)
Board-Certified Psychiatrist (Mental Health & Behavioral Medicine Physician)
Box 32 Service Location & ZIP+4
3905 FORD RD, SUITE 6, PHILADELPHIA, PA, 19131-2824
✓ 9-Digit EDI 837 ZIP+4 (19131-2824)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1669544169 (ABIDEMI ADETOYESE ADEGBOLA, M.D) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
✓ Eligible
Hospice Referring
✓ Eligible
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1669544169 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | ABIDEMI ADETOYESE ADEGBOLA, M.D |
| Plain-English Specialty | Board-Certified Psychiatrist (Mental Health & Behavioral Medicine Physician) NUCC Code: 2084P0800X (Psychiatry & Neurology, Psychiatry) |
| Certifying / Licensing Body | American Board of Psychiatry and Neurology (ABPN) |
| Practice Location Address | 3905 FORD RD, SUITE 6, PHILADELPHIA, PA, 19131-2824 |
| Practice Telephone / Fax | Tel: (215) 220-2196 |
| Administrative Mailing Address | 834 CHESTNUT ST, PHILADELPHIA, PA, 19107-5127 |
| Enumeration & Last Sync | Enumerated: 2006-11-14 | CMS Record Updated: 2021-06-17 |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (2084P0800X)
What Does Taxonomy Code 2084P0800X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 2084P0800X translates to:
"Board-Certified Psychiatrist (Mental Health & Behavioral Medicine Physician)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (ABIDEMI ADETOYESE ADEGBOLA, M.D)
Typical CPT / Diagnostic Procedures:- Comprehensive Psychiatric Diagnostic Evaluation (CPT 90792)
- Psychopharmacological Management & Supportive Psychotherapy
- Medication-Assisted Treatment (MAT) for Substance Use Disorders
- SSRIs & SNRIs (Sertraline, Escitalopram, Fluoxetine, Duloxetine)
- Bupropion, Mirtazapine & Atypical Antipsychotics (Aripiprazole, Quetiapine)
- Buprenorphine/Naloxone & Naltrexone (Addiction Recovery)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
207SG0201X — Medical Genetics, Clinical Genetics (M.D.)Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Clinical Genetics | State: MA | License: 227766 | Primary: Secondary |
2084P0800X — Psychiatry & Neurology, PsychiatryPlain English: Board-Certified Psychiatrist (Mental Health & Behavioral Medicine Physician) | State: NH | License: 13062 | Primary: Secondary |
2084P0804X — Psychiatry & Neurology, Child & Adolescent PsychiatryPlain English: Board-Certified Neurologist (Brain, Spine, Stroke & Nerve Specialist) | State: NH | License: 13062 | Primary: Secondary |
2084P0800X — Psychiatry & Neurology, PsychiatryPlain English: Board-Certified Psychiatrist (Mental Health & Behavioral Medicine Physician) | State: PA | License: MD446583 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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