DR. ADERONKE OLUFUNLOLA BAMGBOSE PEDERSON MD
NPI 1396139655
Psychiatry & Neurology - Psychiatry in Boston, MA

Active since March 25, 2015PECOS EnrolledAccepts Medicare Assignment

NPPES record last updated: June 1, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 1, 2023, Sep 27, 2021, Sep 14, 2021 and 2 more (5 updates tracked since 2017).

About Dr. Aderonke Olufunlola Bamgbose Pederson Md NPPES

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

DR. ADERONKE OLUFUNLOLA BAMGBOSE PEDERSON MD (NPI 1396139655) is an individual psychiatry provider in Boston, Massachusetts, licensed in Massachusetts (T290198) and active in the NPI registry since March 2015. She is enrolled in Medicare PECOS, maintains a secondary practice location in Weymouth, and is a graduate of Northwestern University Feinberg Medical School (2015).

NPPES Registry Identity

NPI1396139655
Entity TypeIndividualFemale
Primary Taxonomy2084P0800X
Provider Legal NameDR. ADERONKE OLUFUNLOLA BAMGBOSE PEDERSONCredential: MD
Location Address55 FRUIT STBoston, MA 02114-2621
Mailing Address64 Bertwell RdLexington, MA 02420-3330 · (773) 310-3224
Sole ProprietorNo
Medical School CMSNorthwestern University Feinberg Medical SchoolGraduated 2015
Enumeration DateMarch 25, 2015
Last NPPES UpdateJune 1, 20235 updates tracked since enumeration
NPPES CertifiedJune 1, 2023
NPI 1396139655 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
Licenses Licensed in MA · T290198 Licensed in IL · 1396139655
Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

55 FRUIT ST, Boston, MA 02114

Other Names 1

Former Name (1)Aderonke Olufunlola Bamgbose

Secondary Practice Location 1

Location 155 Fogg RdWeymouth, MA 02190-2432 · Phone (781) 624-8000

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Aderonke Olufunlola Bamgbose Pederson Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2567745318
PECOS Enrollment IDI20210930002257
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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
79 services76 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02114 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
$189.86 typical visit price
range $63.72 – $189.86
Typical copayment $47.46 (range $15.93 – $47.46)
Most-billed visit code 99205
Established Patient
$78.84 typical visit price
range $21.07 – $155.29
Typical copayment $19.71 (range $5.26 – $38.82)
Most-billed visit code 99213
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.

Internal Medicine (Gastroenterology)
55 FRUIT ST
BOSTON, MA 02114
Psychiatry & Neurology (Psychiatry)
55 FRUIT ST, WARREN 1220
BOSTON, MA 02114
Internal Medicine (Gastroenterology)
55 FRUIT ST
BOSTON, MA 02114
Internal Medicine
55 FRUIT ST, 4710B
BOSTON, MA 02114
Thoracic Surgery (Cardiothoracic Vascular Surgery)
55 FRUIT ST, BUL 119
BOSTON, MA 02114
Thoracic Surgery (Cardiothoracic Vascular Surgery)
55 FRUIT ST, MGH, BULFINCH 2
BOSTON, MA 02114
Urology
55 FRUIT ST, GRB 1102
BOSTON, MA 02114
Anesthesiology
55 FRUIT ST, CLN 3
BOSTON, MA 02114

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1396139655, enumerated as an "individual" on March 25, 2015.

The provider is located at 55 FRUIT ST BOSTON, MA 02114 and the phone number is (617) 724-4100.

Psychiatry & Neurology with taxonomy code 2084P0800X and a focus in Psychiatry.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield and Harvard. Please consult your insurance carrier or call the provider to verify.