ADEOLA MUSTAPHA (MD) – Student in an Organized Health Care Education/Training Program, NPI 1093956765
Student in an Organized Health Care Education/Training Program
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
528 PSYCHIATRY in IN
Provider Addresses for ADEOLA MUSTAPHA (MD)
550 CONGRESSIONAL BLVD
CARMEL, IN 460325609
Phone: (833) 351-8255
Fax: (888) 815-3583
Type: Mailing
109 W 27th St Rm 5S
New York, NY 100016208
Phone: (833) 351-8255
Fax: (888) 815-3583
Type: Location
10 W Broadway
Salt Lake City, UT 841012002
Phone: (833) 351-8255
Fax: (888) 815-3583
Type: Location
4121 Marvin D Love Fwy Ste 2010
Dallas, TX 752244863
Phone: (214) 375-0888
Fax: (214) 375-0887
Type: Location
Good Samaritan Hospital, 520, South 7th Street, Vincennes, Knox County, Indiana, 47591, United States
VINCENNES, IN 475911038
Phone: (812) 882-5220
Type: Location
520 S. SEVENTH ST. VINCENNES
VINCENNES, IN 47591
Phone: (812) 885-3228
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2026-01-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20260115002940 | I | Psychiatry | IN | TBD |
| I20260122001542 | I | Psychiatry | NY | TBD |
| I20260129001107 | I | Psychiatry | UT | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 46032)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P S Y C H I A T R Y | FL | |
| P S Y C H I A T R Y | MI | |
| P S Y C H I A T R Y | NY | |
| Clinical Social Worker | FL | |
| P S Y C H I A T R Y | FL | |
| P S Y C H I A T R Y | CO | |
| P S Y C H I A T R Y | NY | |
| Clinical Social Worker | MA | |
| P S Y C H I A T R Y | NY | |
| P S Y C H I A T R Y | IL |
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