EGEDE J. AITSEBAOMO MD – NPI #1376620682
Internal Medicine

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

Health Care Provider Taxonomy Code for Internal Medicine

EGEDE AITSEBAOMO is a physician located in SAYRE, PA. NPPES has assigned the NPI number 1376620682 to EGEDE AITSEBAOMO on November 01, 2006. It is a Type-1 NPI, indicating this NPI number is associated with an individual. The primary taxonomy selected by this provider is 207RC0000X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Cardiovascular Disease

The NPI profile was previously updated about 5 years ago on Mar 14, 2021. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for EGEDE AITSEBAOMO below.

NPI Profile for
EGEDE J. AITSEBAOMO

NPI Number
1376620682
Enumeration Date

(more than 19 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
EGEDE J. AITSEBAOMO
Credentials
MD
Primary location
1 GUTHRIE SQ
SAYRE, PA 18840-1625
Phone: (570) 887-2289 Fax: (570) 887-2290
Mailing address
Same as primary location
Sole Proprietor
No
Updated
Certification Date
Mar 14, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for EGEDE AITSEBAOMO

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDNC8913023
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207RC0000X
- Internal Medicine / Cardiovascular Disease (Primary)		 NY 285781

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Additional Information

Education
UNIVERSITY OF TEXAS MEDICAL SCHOOL AT HOUSTON - Graduated 1997
Offers Telehealth Services
Yes - Telehealth services allows you to talk to your health care provider using audio/video communications, such as Zoom, without actually going in to the doctor's office
Accepts Medicare
This provider accepts Medicare-approved amount as payment in full. The Medicare-approved amount is the total the provider can be paid. When a provider accepts the Medicare-approved amount as payment, you won't be billed for more than the Medicare deductible & coinsureance.
Medicare Ordering & Referring
Provider can:
  • Refer to Part B
  • Order Durable Medical Equipment
  • Refer to Home Health Agency
  • Order Power Mobility Devices
Affiliations
EGEDE AITSEBAOMO is affiliated with the following medical group(s):
  • HOSPITAL
    • CORNING HOSPITAL
      1 GUTHRIE DRIVE
      CORNING, NY 14830
    • ROBERT PACKER HOSPITAL
      ONE GUTHRIE SQUARE
      SAYRE, PA 18840
    • TROY COMMUNITY HOSPITAL
      275 GUTHRIE DRIVE
      TROY, PA 16947

Why is my NPI data (personal information) being displayed publicly?
If you have an active NPI profile, your profile is required to be disclosed according to the FOIA and eFOIA. HIPAA also requires covered providers to share their NPI with other providers, health plans, clearinghouses and any entity that may need it for billing purposes.

How do I correct or change the NPI data displayed here?
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Can I hide my NPI profile from the public?
Unfortunately, No. The NPPES discloses health care provider data under the Freedom of Information Act to the public, which means anyone may request such information directly from the National Plan & Provider Enumeration System. See the complete CMS Data Dissemination Notice here.