DR. ANTHONY ADETOLA ODUBANJO M.D.
NPI 1659786754
Internal Medicine - Critical Care Medicine in Atlanta, GA

Q: What is Anthony Odubanjo's NPI number?

The NPI number for Anthony Odubanjo is 1659786754. It was assigned to this individual provider in the NPPES registry on June 26, 2014.

Q: What is Anthony Odubanjo's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Critical Care Medicine, with taxonomy code 207RC0200X.

Q: When was this NPI record last updated?

The NPPES record for Anthony Odubanjo was last updated on July 2, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since June 26, 2014PECOS EnrolledAccepts Medicare Assignment

960 JOHNSON FERRY RD STE 500, ATLANTA, GA 30342(404) 257-0006(404) 851-1316 Get Directions Write a Review

NPPES record last updated: July 2, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Nov 12, 2020, Jul 9, 2019 (2 updates tracked since 2019).

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About Dr. Anthony Adetola Odubanjo M.d. NPPES

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

DR. ANTHONY ADETOLA ODUBANJO M.D. (NPI 1659786754) is an individual critical care medicine provider in Atlanta, Georgia, licensed in Georgia (86557) and active in the NPI registry since June 2014. He is enrolled in Medicare PECOS, is affiliated with Northside Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1659786754

Entity TypeIndividualMale

Primary Taxonomy207RC0200X

Provider Legal NameDR. ANTHONY ADETOLA ODUBANJOCredential: M.D.

Location Address960 JOHNSON FERRY RD STE 500Atlanta, GA 30342-1630

Mailing Address960 Johnson Ferry Rd Ste 500Atlanta, GA 30342-1630 · (404) 257-0006 · Fax (404) 851-1316

Phone(404) 257-0006

Fax(404) 851-1316

Sole ProprietorNo

Medical School CMSOtherGraduated 2008

Enumeration DateJune 26, 2014

Last NPPES UpdateJuly 2, 20222 updates tracked since enumeration

NPPES CertifiedJuly 2, 2022

✔ NPI 1659786754 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Critical Care MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207RC0200X

License✔ Licensed in GA · 86557

Definition

An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.

Also ListedInternal MedicineTaxonomy 207R00000X · License MD22279 (ME)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

960 JOHNSON FERRY RD STE 500, Atlanta, GA 30342

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Secondary Practice Locations 2

Location 11 Brookdale PlzBrooklyn, NY 11212-3139 · Phone (571) 201-9753

Location 23 Glen Cove Dr Ste 3Rockport, ME 04856-4232 · Phone (207) 301-5400 · Fax (207) 301-5301

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Anthony Adetola Odubanjo M.d. 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 ID2466704101

PECOS Enrollment IDI20210225000745, I20260417000670

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.

Medicare Billing Reassignments

Medicare enrollment records show Anthony Odubanjo reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Northside Primary Care Professional Services,llc

0.1 mi

Family Medicine

1000 JOHNSON FERRY RD NE
Atlanta, GA 30342

Reassigned Medicare billing, Georgia enrollment
466 clinicians in this Medicare group

NPI 1922397553 (855) 709-4535

Mcleod Health Clarendon

239 mi

Nurse Anesthetist, Certified Registered

10 E HOSPITAL ST
Manning, SC 29102

Reassigned Medicare billing, South Carolina enrollment
215 clinicians in this Medicare group

NPI 1508218793 (843) 435-8463

Mcleod Medical Center-Dillon

288 mi

Hospitalist

301 E JACKSON ST
Dillon, SC 29536

Reassigned Medicare billing, South Carolina enrollment
126 clinicians in this Medicare group

NPI 1720033988 (843) 774-4111

Sound Physicians Of Massachusetts Inc

860 mi

Internal Medicine

71 HOSPITAL AVE
North Adams, MA 01247

Reassigned Medicare billing, Maine enrollment
41 clinicians in this Medicare group

NPI 1205164951 (413) 664-5000

Nes Medical Services Of New England Inc

1,120 mi

Emergency Medicine

360 BROADWAY
Bangor, ME 04401

Reassigned Medicare billing, Maine enrollment
54 clinicians in this Medicare group

NPI 1396401907 (207) 907-3000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims

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

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

45 services42 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Northside Hospital

Acute Care Hospitals · Atlanta, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110161

Location1000 Johnson Ferry Road, NEAtlanta, GA 30342 · Fulton County

Birthing friendly

Mcleod Health Clarendon

Acute Care Hospitals · Manning, SC

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number420109

Location10 East Hospital StreetManning, SC 29102 · Clarendon County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30342 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

$130.64 typical visit price

range $56.84 – $172.43

Typical copayment $32.66 (range $14.21 – $43.10)

Most-billed visit code 99204

Established Patient

$100.20 typical visit price

range $18.22 – $140.40

Typical copayment $25.05 (range $4.55 – $35.10)

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.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

1 supplier16 claims16 services$16.46 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

1 supplier18 claims18 services$76.96 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 14

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

MRS. LASONJA S REEVES P.A.-C

Physician Assistant (Medical)