Dr Kwami Delali Agbodza, MD is a medicare enrolled "Preventive Medicine - Preventive Medicine/occupational Environmental Medicine" physician in Jackson, New Jersey. His current practice location is
15 Westlake Ct, Jackson, New Jersey. You can reach out to his office (for appointments etc.) via phone at
(732) 961-6453.
Dr Kwami Delali Agbodza is licensed to practice in New York (license number 20436001) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1831190172.
Physician's Profile
| Full Name | Dr Kwami Delali Agbodza |
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| Gender | Male |
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| Speciality | Preventive Medicine - Preventive Medicine/occupational Environmental Medicine |
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| Location | 15 Westlake Ct, Jackson, New Jersey |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1831190172
- Provider Enumeration Date: 08/09/2005
- Last Update Date: 07/08/2025
Medicare PECOS Information:
- PECOS PAC ID: 1951389501
- Enrollment ID: I20071219000441
Medical Identifiers
Medical identifiers for Dr Kwami Delali Agbodza such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1831190172 | NPI | - | NPPES |
| 6420109 | Medicaid | NJ | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207P00000X | Emergency Medicine | 9500799 (North Carolina) | Secondary |
| 2083P0500X | Preventive Medicine - Preventive Medicine/occupational Environmental Medicine | 20436001 (New York) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Kwami Delali Agbodza allows following entities to bill medicare on his behalf.
| Entity Name | Upstate Ny Physician Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1487484523
PECOS PAC ID: 4183164148
Enrollment ID: O20240905002964 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kwami Delali Agbodza is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Kwami Delali Agbodza, MD
15 Westlake Ct,
Jackson, NJ 08527-5160
Ph: (732) 961-6453 | Dr Kwami Delali Agbodza, MD
15 Westlake Ct,
Jackson, NJ 08527-5160
Ph: (732) 961-6453 |
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