DR. ADERONKE OLUFUNLOLA BAMGBOSE PEDERSON (MD) – Psychiatry Physician, NPI 1396139655
Psychiatry Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,367 PSYCHIATRY in IL
Provider Addresses for DR. ADERONKE OLUFUNLOLA BAMGBOSE PEDERSON (MD)
1258 W CORNELIA AVE APT 1
CHICAGO, IL 606571456
Phone: (773) 310-3224
Type: Mailing
446 E ONTARIO ST STE 6TH
CHICAGO, IL 606114418
Phone: (312) 926-8200
Type: Location
55 FRUIT ST
BOSTON, MA 021142621
Phone: (617) 724-4100
Type: Location
55 Fogg Rd
Weymouth, MA 021902432
Phone: (781) 624-8000
Type: Location
64 BERTWELL RD
LEXINGTON, MA 024203330
Phone: (773) 310-3224
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $5,335.
Total Amount is formed as General ($5,335) + Research ($0) + Ownership ($0) = $5,335.
Last reported payment date: 2024-02-06 • Largest payer in this snapshot: Otsuka Pharmaceutical Development & Commercialization, Inc. ($5,335).
Total Amount
$5,335
General + Research + Ownership
Payments
4
Total payment records
General Amount
$5,335
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-02-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Otsuka Pharmaceutical Development & Commercialization, Inc. | $5,335 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-09-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20210930002257 | I | Psychiatry | MA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 24 | 23 | $0 |
Insurance plans in this area (ZIP 60657)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| G A S T R O E N T E R O L O G Y | MA | |
| Diagnostic Radiology | MA | |
| Nephrology, Internal Medicine | MA | |
| Nurse Practitioner | MA | |
| P A T H O L O G Y | NY | |
| P A T H O L O G Y | MA | |
| P S Y C H I A T R Y | MA | |
| Cardiac Electrophysiology, Internal Medicine, Cardiovascular Disease (Cardiology) | MA | |
| H E M A T O L O G Y/ O N C O L O G Y | MA | |
| N E U R O L O G Y | MA |
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