Dr Ejiro Vivian Agboro-idahosa, MD in Elmira, NY

Dr Ejiro Vivian Agboro-idahosa, MD is a medicare enrolled "Psychiatry & Neurology - Child & Adolescent Psychiatry" physician in Elmira, New York. She graduated from medical school in 1994 and has 30 years of diverse experience with area of expertise as Psychiatry. She is a member of the group practice Waverly Medical Associates Llc and her current practice location is 555 Saint Josephs Blvd, Elmira, New York. You can reach out to her office (for appointments etc.) via phone at (607) 737-7002.

Dr Ejiro Vivian Agboro-idahosa is licensed to practice in Iowa (license number 38473) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1104089390.

Contact Information

	Dr Ejiro Vivian Agboro-idahosa, MD
	555 Saint Josephs Blvd, Elmira, NY 14901-3223
	(607) 737-7002
	(607) 737-1529

Map and Direction

Physician's Profile

Full Name	Dr Ejiro Vivian Agboro-idahosa
Gender	Female
Speciality	Psychiatry
Experience	30 Years
Location	555 Saint Josephs Blvd, Elmira, New York
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Dr Ejiro Vivian Agboro-idahosa graduated from medical school in 1994

NPI Data:

NPI Number: 1104089390
Provider Enumeration Date: 07/08/2008
Last Update Date: 06/08/2016

Medicare PECOS Information:

PECOS PAC ID: 1355495649
Enrollment ID: I20150617001896

Medical Identifiers

Medical identifiers for Dr Ejiro Vivian Agboro-idahosa such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1104089390	NPI	-	NPPES
38473	Other	IA	IOWA LICENSE
275859	Other	NY	STATE LICENSE
1243767	Other	IA	CONTROLLED SUBSTANCE CERTIFICATE
04061661	Medicaid	NY

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2084P0800X	Psychiatry & Neurology - Psychiatry	38473 (Iowa)	Secondary
2084P0804X	Psychiatry & Neurology - Child & Adolescent Psychiatry	38473 (Iowa)	Primary
2084P0800X	Psychiatry & Neurology - Psychiatry	275859 (New York)	Secondary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Waverly Medical Associates Llc	0547589541	2

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Ejiro Vivian Agboro-idahosa allows following entities to bill medicare on her behalf.

Entity Name	Waverly Medical Associates Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1457757486 PECOS PAC ID: 0547589541 Enrollment ID: O20150424000126

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Ejiro Vivian Agboro-idahosa is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Ejiro Vivian Agboro-idahosa, MD 571 Saint Josephs Blvd Fl 2, Elmira, NY 14901-3230 Ph: (607) 271-2050	Dr Ejiro Vivian Agboro-idahosa, MD 555 Saint Josephs Blvd, Elmira, NY 14901-3223 Ph: (607) 737-7002

Reviews and Comments

Psychiatry & Neurology Doctors in Elmira, NY

Miss April Laverne Roberts, DO Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 100 N Main Street, Suite 200, Elmira, NY 14901 Phone: 607-735-9878 Fax: 607-735-9877
Dr. Albert K Chen, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 361 W Water St, Elmira, NY 14905 Phone: 607-733-0780
Hannah Rose Bushnell, D.O. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 571 Saint Josephs Blvd Ste 304, Elmira, NY 14901 Phone: 607-737-7012 Fax: 607-735-5594
Shahindokht Buchan, M.D. Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 100 Washington St, Elmira, NY 14901 Phone: 607-737-4810
Ms. Chunying Xu, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 555 Saint Josephs Blvd, Elmira, NY 14901 Phone: 607-733-6541 Fax: 607-737-7529
Dr. Herman Berliss, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 22 Graycliff Dr, Elmira, NY 14903 Phone: 607-737-1326

Dr Ejiro Vivian Agboro-idahosa, MD - Medicare Psychiatry in Elmira, NY