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ADETOLA SAMSON ADEBOLA MD
NPI 1124602958
Internal Medicine in Corvallis, OR

Active since May 07, 2021PECOS Enrolled
3600 NW SAMARITAN DR, CORVALLIS, OR 97330(541) 768-4906 Get Directions Write a Review

NPPES record last updated: May 7, 2021. Verified against the NPPES registry weekly; last sync: September 27, 2026.

About Adetola Samson Adebola Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ADETOLA SAMSON ADEBOLA MD (NPI 1124602958) is an individual internal medicine provider in Corvallis, Oregon, licensed in Oregon (PG205256) and active in the NPI registry since May 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124602958
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameADETOLA SAMSON ADEBOLACredential: MD
Location Address3600 NW SAMARITAN DRCorvallis, OR 97330-3737
Mailing Address3600 Nw Samaritan DrCorvallis, OR 97330-3737 · (541) 768-4906
Phone(541) 768-4906
Sole ProprietorNo
Enumeration DateMay 7, 2021
NPPES CertifiedMay 7, 2021
✔ NPI 1124602958 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in OR · PG205256
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
3600 NW SAMARITAN DR, Corvallis, OR 97330
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Adetola Samson Adebola Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97330 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.25 typical visit price
range $54.96 – $166.64
Typical copayment $31.56 (range $13.74 – $41.66)
Most-billed visit code 99204
Established Patient
$97.16 typical visit price
range $17.68 – $136.19
Typical copayment $24.29 (range $4.42 – $34.04)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ELIZABETH BURNS MCQUITTY M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
3600 NW SAMARITAN DR, PATHOLOGY DEPT
CORVALLIS, OR 97330
Benton County (541) 768-6697
MS. KIM SCHLESSINGER ANP-BC
Nurse Practitioner (Adult Health)
3600 NW SAMARITAN DR
CORVALLIS, OR 97330
Benton County (541) 768-6687
DR. PARINAV KANWAR
Student in an Organized Health Care Education/Training Program
3600 NW SAMARITAN DR
CORVALLIS, OR 97330
Benton County (541) 768-4906
SAMUEL ARNOT DO
Internal Medicine
3600 NW SAMARITAN DR
CORVALLIS, OR 97330
Benton County (541) 768-5111
DANIELLE MICHELLE NIEMANN DO
Student in an Organized Health Care Education/Training Program
3600 NW SAMARITAN DR
CORVALLIS, OR 97330
Benton County (541) 768-4906
MOHAN AVULA DO
Internal Medicine
3600 NW SAMARITAN DR
CORVALLIS, OR 97330
Benton County (541) 768-4906
DR. RANDALL V. BREAM M.D.
Internal Medicine (Cardiovascular Disease)
3600 NW SAMARITAN DR, SUITE E350
CORVALLIS, OR 97330
Benton County (541) 768-5205
DR. DESTINY JENNIFER GMELCH M.D.
Pediatrics
3600 NW SAMARITAN DR
CORVALLIS, OR 97330
Benton County (541) 768-5111

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Adetola Adebola's NPI number?

The NPI number for Adetola Adebola is 1124602958. It was assigned to this individual provider in the NPPES registry on May 7, 2021.

Where is Adetola Adebola located?

Adetola Adebola practices at 3600 NW Samaritan Dr, Corvallis, OR 97330. The listed phone number is (541) 768-4906.

What is Adetola Adebola's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Adetola Adebola enrolled in Medicare?

Yes. Adetola Adebola is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Adetola Adebola was last updated on May 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.