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ADEDAMOLA FAWOLE
NPI 1669116430
Counselor - Professional in Philadelphia, PA

Active since April 26, 2022PECOS Enrolled
4500 FRANKFORD AVE, PHILADELPHIA, PA 19124(215) 831-9882 Get Directions Write a Review

NPPES record last updated: October 24, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 24, 2023, Apr 26, 2022 (2 updates tracked since 2022).

About Adedamola Fawole NPPES

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

ADEDAMOLA FAWOLE (NPI 1669116430) is an individual professional provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (PC015942) and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1669116430
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameADEDAMOLA FAWOLE
Location Address4500 FRANKFORD AVEPhiladelphia, PA 19124-3602
Mailing Address48 Jonquil WaySicklerville, NJ 08081-4100 · (267) 442-8415
Phone(215) 831-9882
Sole ProprietorNo
Enumeration DateApril 26, 2022
Last NPPES UpdateOctober 24, 20232 updates tracked since enumeration
NPPES CertifiedOctober 24, 2023
✔ NPI 1669116430 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in PA · PC015942
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License PC015942 (PA)
4500 FRANKFORD AVE, Philadelphia, PA 19124
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Adedamola Fawole 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.

Medicare Billing Reassignments

2

Medicare enrollment records show Adedamola Fawole reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Greater Philadelphia Health Action Inc.
Same address
Federally Qualified Health Center (FQHC)
4510 FRANKFORD AVE
Philadelphia, PA 19124
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 232 clinicians in this Medicare group
NPI 1659325652 (215) 744-1302
Grow Healthcare Group PA
1,025 mi
Mental Health
66 W FLAGLER ST STE 900
Miami, FL 33130
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 833 clinicians in this Medicare group
NPI 1245845932 (786) 244-7711

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

Other Providers at the Same Location NPPES 9

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

ACRO PHARMACEUTICAL SERVICES LLC.
Pharmacy
4500 FRANKFORD AVE
PHILADELPHIA, PA 19124
Philadelphia County (215) 743-4106
MS. REBECCA R CHOITZ CNM
Advanced Practice Midwife
4500 FRANKFORD AVE
PHILADELPHIA, PA 19124
Philadelphia County (215) 744-1302
JUDY TRAN
Dental Hygienist
4500 FRANKFORD AVE
PHILADELPHIA, PA 19124
Philadelphia County (888) 296-4742
SANIYYAH OVERBY
Counselor (Addiction (Substance Use Disorder))
4500 FRANKFORD AVE
PHILADELPHIA, PA 19124
Philadelphia County (215) 831-9882
MELANIE TAYER FNP-BC
Nurse Practitioner (Family)
4500 FRANKFORD AVE
PHILADELPHIA, PA 19124
Philadelphia County (858) 334-8594
GREATER PHILADELPHIA HEALTH ACTION, INC
Pharmacy (Community/Retail Pharmacy)
4500 FRANKFORD AVE
PHILADELPHIA, PA 19124
Philadelphia County (215) 743-4106
ALEXA JADE EVANS WHNP-BC
Nurse Practitioner (Women's Health)
4500 FRANKFORD AVE
PHILADELPHIA, PA 19124
Philadelphia County (888) 296-4742
MS. DANA LYNN DAVIS LCSW
Social Worker (Clinical)
4500 FRANKFORD AVE
PHILADELPHIA, PA 19124
Philadelphia County (888) 296-4742

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 Adedamola Fawole's NPI number?

The NPI number for Adedamola Fawole is 1669116430. It was assigned to this individual provider in the NPPES registry on April 26, 2022.

Where is Adedamola Fawole located?

Adedamola Fawole practices at 4500 Frankford Ave, Philadelphia, PA 19124. The listed phone number is (215) 831-9882.

What is Adedamola Fawole's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Adedamola Fawole enrolled in Medicare?

Yes. Adedamola Fawole is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Adedamola Fawole's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Adedamola Fawole reassigns Medicare benefits to 2 organizations: Greater Philadelphia Health Action Inc. (Philadelphia, PA) and Grow Healthcare Group PA (Miami, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Adedamola Fawole's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Adedamola Fawole accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Adedamola Fawole as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Adedamola Fawole was last updated on October 24, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.