DR. OMODAMOLA ABISOLA AJE – Internal Medicine Physician, NPI 1093207763

DR. OMODAMOLA ABISOLA AJE is a healthcare provider. based in Dorchester, Massachusetts. specializing in ENDOCRINOLOGY. They hold a License No. 275645 (MA). The NPI Number for DR. OMODAMOLA ABISOLA AJE is 1093207763

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
DR. OMODAMOLA ABISOLA AJE
NPI
1093207763
Phone
(617) 506-2726
Address
2100 DORCHESTER AVE
Enumeration Date
30 May 2018
Last Update Date
30 May 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4135288290
Graduation Year
2016 (10 years ago)
PAC ID
8426405960
Group Practice PAC ID
1254240773
Professional Enrollment ID
I20231106002092
Address ID
MA012302148GR780XXSTXX300
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:8State licenses:1Digital endpointsOther names

549 ENDOCRINOLOGY in MA

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Provider Addresses for DR. OMODAMOLA ABISOLA AJE

  • Carney Hospital, 2100, Dorchester Avenue, Lower Mills, Boston, Suffolk County, Massachusetts, 02124, United States

    DORCHESTER, MA 021245615

    Phone: (617) 506-2726

    Type: Location

  • Woodbine Street, Roxbury, Boston, Suffolk County, Massachusetts, 02119, United States

    BOSTON, MA 021192132

    Phone: (316) 744-5650

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $95.

Total Amount is formed as General ($95) + Research ($0) + Ownership ($0) = $95.

Last reported payment date: 2024-10-29 • Largest payer in this snapshot: Amgen Inc. ($95).

Total Amount

$95

General + Research + Ownership

Payments

1

Total payment records

General Amount

$95

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-29

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Amgen Inc.$95
View all Open Payments →|Open Payments Risk Radar →

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: 2023-11-06

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
I20231106002092IEndocrinologyMATBD

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
99204New patient office or other outpatient visit, 45-59 minutes4040$0
99214Established patient office or other outpatient visit, 30-39 minutes2727$0
99215Established patient office or other outpatient visit, 40-54 minutes2020$0
99203New patient office or other outpatient visit, 30-44 minutes1717$0
View full utilization report →

Insurance plans in this area (ZIP 02124)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1254240773View full group profile
NameSpecialtyState
Internal MedicineMA
Internal MedicineMA
A N E S T H E S I O L O G YMA
Internal MedicineMA
Physician AssistantMA
Endocrinology, Internal MedicineMA
Certified Registered Nurse Anesthetist (Crna)NY
Emergency MedicineMA
Family PracticeMA
-OR

Reviews

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Frequently asked questions

How do I look up DR. OMODAMOLA ABISOLA AJE by NPI?
Use NPI 1093207763 when you need to reference DR. OMODAMOLA ABISOLA AJE in forms, claims, or directories.
Is DR. OMODAMOLA ABISOLA AJE's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does DR. OMODAMOLA ABISOLA AJE treat or focus on?
Patients typically see DR. OMODAMOLA ABISOLA AJE under the specialty Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Does DR. OMODAMOLA ABISOLA AJE practice in Massachusetts?
You will see Dorchester, Massachusetts on file for DR. OMODAMOLA ABISOLA AJE alongside any extra practice locations.
How can I contact DR. OMODAMOLA ABISOLA AJE?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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