DR. OLUWABUKOLA PRINCESS ADASOFUNJO (M.D.) – Pediatrics Physician, NPI 1114360666
Pediatrics Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. OLUWABUKOLA PRINCESS ADASOFUNJO (M.D.)
11100 EUCLID AVE
CLEVELAND, OH 441061716
Phone: (216) 844-4960
Fax: (216) 844-1949
Type: Mailing
4117 TRACY CIR
SULPHUR, LA 706635442
Phone: (312) 731-7525
Type: Location
FORT HEALTH
613 WASHINGTON BLVD
JERSEY CITY, NJ 07310
Phone: (201) 208-2616
Fax: (973) 250-4028
Type: Mailing
87 RTE 17 N
STE 118
MAYWOOD, NJ 07607
Phone: (551) 996-4450
Fax: (551) 996-5729
Type: Location
194 N Harrison St
Princeton, NJ 085403516
Phone: (609) 445-3315
Type: Location
30 PROSPECT AVE
HACKENSACK, NJ 076011915
Phone: (551) 996-4450
Fax: (551) 996-5729
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 $125.
Total Amount is formed as General ($125) + Research ($0) + Ownership ($0) = $125.
Last reported payment date: 2024-06-26 • Largest payer in this snapshot: Axsome Therapeutics, Inc. ($125).
Total Amount
$125
General + Research + Ownership
Payments
1
Total payment records
General Amount
$125
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-26
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Axsome Therapeutics, Inc. | $125 |
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: 2022-01-14
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 |
|---|---|---|---|---|
| I20220114001104 | I | Pediatric Medicine | NJ | 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 44106)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OH | |
| - | OH | |
| Nurse Practitioner | OH | |
| Clinical Social Worker | OH | |
| Clinical Social Worker | OH | |
| Nurse Practitioner | OH | |
| Clinical Social Worker | OH | |
| - | OH | |
| - | OH | |
| - | OH |
Reviews
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