DR. ADEMOLA FAWOLE
NPI 1871080358
Psychologist in Hershey, PA

Active since April 19, 2018PECOS EnrolledAccepts Medicare Assignment
513 W CHOCOLATE AVE STE 100, HERSHEY, PA 17033(717) 810-1974(717) 704-8476 Get Directions Write a Review

NPPES record last updated: August 14, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 14, 2019, Apr 19, 2018 (2 updates tracked since 2018).

About Dr. Ademola Fawole NPPES

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

DR. ADEMOLA FAWOLE (NPI 1871080358) is an individual psychologist in Hershey, Pennsylvania, licensed in Pennsylvania (PS018734) and active in the NPI registry since April 2018. He is enrolled in Medicare PECOS, maintains a secondary practice location in Menasha, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1871080358
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameDR. ADEMOLA FAWOLE
Location Address513 W CHOCOLATE AVE STE 100Hershey, PA 17033
Mailing Address2726 Maxwell StPhiladelphia, PA 19136-1017 · (215) 939-0572
Fax(717) 704-8476
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateApril 19, 2018
Last NPPES UpdateAugust 14, 20192 updates tracked since enumeration
✔ NPI 1871080358 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Licenses✔ Licensed in PA · PS018734✔ Licensed in WI · 3565-57
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
513 W CHOCOLATE AVE STE 100, Hershey, PA 17033

Secondary Practice Location 1

Location 11427C Province TerMenasha, WI 54952-7003 · Phone (920) 738-9999 · Fax (920) 268-1921

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. Ademola Fawole 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 ID7618216151
PECOS Enrollment IDI20250602003005
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

3

Medicare enrollment records show Ademola Fawole reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mental Health
221 RIVER ST. FL 9
Hoboken, NJ 07030
  • Reassigned Medicare billing, New Jersey enrollment
  • 673 clinicians in this Medicare group
Clinical
140 E RIDGEWOOD AVE STE 415
Paramus, NJ 07652
  • Reassigned Medicare billing, New Jersey enrollment
  • 116 clinicians in this Medicare group
Mental Health
66 W FLAGLER ST STE 900
Miami, FL 33130
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 833 clinicians in this Medicare group

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 6

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

General Practice
513 W CHOCOLATE AVE STE 100
HERSHEY, PA 17033
Social Worker
513 W CHOCOLATE AVE STE 100
HERSHEY, PA 17033
Psychologist
513 W CHOCOLATE AVE STE 100
HERSHEY, PA 17033
Counselor
513 W CHOCOLATE AVE STE 100
HERSHEY, PA 17033
Counselor
513 W CHOCOLATE AVE STE 100
HERSHEY, PA 17033
Marriage & Family Therapist
513 W CHOCOLATE AVE STE 100
HERSHEY, PA 17033

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 Ademola Fawole's NPI number?

The NPI number for Ademola Fawole is 1871080358. It was assigned to this individual provider in the NPPES registry on April 19, 2018.

Where is Ademola Fawole located?

Ademola Fawole practices at 513 W Chocolate Ave Ste 100, Hershey, PA 17033. The listed phone number is (717) 810-1974.

What is Ademola Fawole's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Ademola Fawole enrolled in Medicare?

Yes. Ademola Fawole is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Ademola Fawole's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ademola Fawole reassigns Medicare benefits to 3 organizations: Grow Healthcare Group Of New Jersey PC (Hoboken, NJ), Nj Behavioral Health Services PC (Paramus, NJ) 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 Ademola Fawole's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Ademola Fawole was last updated on August 14, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.