FATAI BOLAJI ADISA (PT) – Physical Therapist, NPI 1710930011

FATAI BOLAJI ADISA (PT) is a healthcare provider. based in Merrillville, Indiana. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. 05005905A (IN). The NPI Number for FATAI BOLAJI ADISA (PT) is 1710930011

Main info

Male
Sole Proprietor
35 Years Of Experience
Accepts Medicare Assignment
Name
FATAI BOLAJI ADISA (PT)
NPI
1710930011
Phone
(219) 525-4176
Address
PO BOX 10644
Enumeration Date
18 May 2006
Last Update Date
20 November 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2195254176
Graduation Year
1991 (35 years ago)
PAC ID
0143296756
Professional Enrollment ID
I20141203001184
Address ID
IN464105549ME8687XSTXX302
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,866 PHYSICAL THERAPIST IN PRIVATE PRACTICE in IN

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Provider Addresses for FATAI BOLAJI ADISA (PT)

  • PO BOX 10644

    MERRILLVILLE, IN 464110644

    Phone: (219) 525-4176

    Fax: (219) 750-9451

    Type: Mailing

  • Derek M. Stephens, DDS, 8691, Connecticut Street, Merrillville, Ross Township, Lake County, Indiana, 46410, United States

    STE C

    MERRILLVILLE, IN 464105541

    Phone: (219) 525-4176

    Fax: (219) 472-0841

    Type: Location

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: 2014-12-03

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20141203001184IPhysical Therapist In Private PracticeINTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes55420$0
97140Therapy procedure using manual technique, each 15 minutes41520$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes30421$0
G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care18513$0
97162Evaluation for physical therapy, typically 30 minutes1413$0
View full utilization report →

Insurance plans in this area (ZIP 46411)

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Provider's Procedures

FATAI BOLAJI ADISA (PT) performs procedures in PHYSICAL THERAPIST IN PRIVATE PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYIN97110Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes94649
PHYSICAL THERAPYIN97140Manual (physical) therapy techniques to 1 or more regions, each 15 minutes41844

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Frequently asked questions

What number should I use to identify FATAI BOLAJI ADISA (PT) for billing?
Administrative and clinical systems typically use NPI 1710930011 for FATAI BOLAJI ADISA (PT).
Does the public listing show FATAI BOLAJI ADISA (PT) as active?
FATAI BOLAJI ADISA (PT)'s NPI record reflects an active status in NPPES.
What does the directory say FATAI BOLAJI ADISA (PT) does?
Insurance directories may phrase it differently, but here FATAI BOLAJI ADISA (PT) maps to Physical Therapist. Clinical services aligned with this taxonomy classification.
What geographic area is tied to FATAI BOLAJI ADISA (PT)?
FATAI BOLAJI ADISA (PT) is associated with Merrillville, Indiana in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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