Individual provider

Ejiro Agboro-idahosa, M.D

Child & Adolescent Psychiatry Physician Psychiatry Physician Medicare enrolled

Ejiro Agboro-idahosa, M.D is a Child & Adolescent Psychiatry Physician in Elmira, NY, registered under NPI 1104089390. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty.

Getting there

The practice address on file is 555 SAINT JOSEPHS BLVD, Elmira, NY 14901. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

555 SAINT JOSEPHS BLVD, Elmira, NY 14901 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
38473 IA Child & Adolescent Psychiatry Physician primary
38473 IA Psychiatry Physician
275859 NY Psychiatry Physician

Licences are recorded in 2 states: IA, NY. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.

Medicare (PECOS)
Status
Approved
Provider type
Practitioner - Psychiatry
PAC ID
1355495649

Medicare enrolment is recorded as approved under the provider type Practitioner - Psychiatry. This means the provider is enrolled to bill Medicare, though it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

Licensed in 2 states

This provider holds licences in 2 states: Iowa and New York. The practice address on file is in Elmira, NY, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.

IA Iowa
Licence
38473
Specialty
Child & Adolescent Psychiatry Physician
Verify with the IA board →
NY New York practice address
Licence
275859
Specialty
Psychiatry Physician
Verify with the NY board →

Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.

What Child & Adolescent Psychiatry covers

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. NUCC Health Care Provider Taxonomy, code 2084P0804X
Allopathic & Osteopathic Physicians Psychiatry & Neurology Child & Adolescent Psychiatry

All registered taxonomy codes

This provider registers 3 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
2084P0804X Child & Adolescent Psychiatry Physician Child & Adolescent Psychiatry 38473 IA primary
2084P0800X Psychiatry Physician Psychiatry 38473 IA
2084P0800X Psychiatry Physician Psychiatry 275859 NY

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1104089390 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateJul 8, 2008
Last updatedJun 8, 2016
StatusActive
Sole proprietorNo
CredentialM.D
Practice address 555 SAINT JOSEPHS BLVD
Elmira, NY 14901
(607) 737-7002
Fax (607) 737-1529
Mailing address 571 SAINT JOSEPHS BLVD FL 2
Elmira, NY 14901
Other identifiers 38473 · IOWA LICENSE (IA)
275859 · STATE LICENSE (NY)
1243767 · CONTROLLED SUBSTANCE CERTIFICATE (IA)
04061661 (NY)
This record was last updated on Jun 8, 2016, roughly 10 years ago. Address and phone details that old are frequently out of date. Verify by phone before travelling to the address shown.

Number check

1104089390 passes the NPI check digit test The final digit 0 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 1 0 4 0 8 9 3 9
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 1 0 4 0 8 9 3 9

Sum = 60 · next multiple of 10 = 60 · check digit = 0 · actual last digit = 0

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1104089390?
NPI 1104089390 is the National Provider Identifier assigned to Ejiro Agboro-idahosa, M.D in Elmira, NY. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Child & Adolescent Psychiatry cover?
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
How do I contact Ejiro Agboro-idahosa, M.D?
The phone number on file with NPPES is (607) 737-7002, last updated Jun 8, 2016. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does Ejiro Agboro-idahosa, M.D accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1104089390 a valid number?
Yes. 1104089390 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.