Dr Emmanuel Adekunle Adedokun, MD is a medicare enrolled "General Practice" physician in Clifton, New Jersey. His current practice location is
1135 Broad St Ste 201, Clifton, New Jersey. You can reach out to his office (for appointments etc.) via phone at
(973) 754-4100.
Dr Emmanuel Adekunle Adedokun is licensed to practice in Michigan (license number 4301102418) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1417158767.
Physician's Profile
| Full Name | Dr Emmanuel Adekunle Adedokun |
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| Gender | Male |
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| Speciality | General Practice |
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| Location | 1135 Broad St Ste 201, Clifton, New Jersey |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1417158767
- Provider Enumeration Date: 05/31/2007
- Last Update Date: 06/21/2024
Medicare PECOS Information:
- PECOS PAC ID: 7517392921
- Enrollment ID: I20200127001906
Medical Identifiers
Medical identifiers for Dr Emmanuel Adekunle Adedokun such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1417158767 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | 047380 (Connecticut) | Secondary |
| 207Q00000X | Family Medicine | 4301102418 (Michigan) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 208D00000X | General Practice | 4301102418 (Michigan) | Primary |
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 Emmanuel Adekunle Adedokun allows following entities to bill medicare on his behalf.
| Entity Name | Signify Health Medical Associates Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1750845863
PECOS PAC ID: 2163764424
Enrollment ID: O20210405000855 |
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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 Emmanuel Adekunle Adedokun 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 |
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Dr Emmanuel Adekunle Adedokun, MD
900 Lynn Garden Dr,
Kingsport, TN 37665-2145
Ph: (931) 432-8691 | Dr Emmanuel Adekunle Adedokun, MD
1135 Broad St Ste 201,
Clifton, NJ 07013-3346
Ph: (973) 754-4100 |
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