Adebowale Shadrach Salako, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1060750 Issued in TX

Practice address

9101 Highway 6 N
Houston, TX 77095-2302

Phone

(281) 859-3210

NPI assigned

Jul 24, 2021

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Minuteclinic Diagnostic of Texas PLLC 253 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles (4 of 8)

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: adebowale.salako.1@19152.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Minuteclinic Diagnostic of Texas PLLC

  • Family Nurse Practitioner
  • Round Rock, TX
  • NPI 1609076330

  Family, TX

  Medicare reassignment Care Compare group NPD
• Minuteclinic Primary Care Texas PLLC

  • Family Nurse Practitioner
  • Spring, TX
  • NPI 1710794292

  Family, TX

  Medicare reassignment NPD
• Minuteclinic Telehealth Services of Texas Association

  • Family Nurse Practitioner
  • Round Rock, TX
  • NPI 1922564301

  Family, TX

  Medicare reassignment NPD
• Minuteclinic Diagnostic of Texas PLLC

  • Clinical Social Worker
  • Katy, TX
  • NPI 1740898188
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1013580240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9101 HIGHWAY 6 N",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770952302",
            "telephone_number": "281-859-3210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9101 HIGHWAY 6 N",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770952302",
            "telephone_number": "281-859-3210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALAKO",
        "first_name": "ADEBOWALE",
        "middle_name": "SHADRACH",
        "name_prefix": "Mr.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-24",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "853775",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1060750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013580240",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "cvshealth.com",
            "affiliation": "N",
            "endpointDescription": "Clinic",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9101 Highway 6 N",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770952302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nicole Colleen Saladino, LPC
• Moiz Salahuddin
• Abdulla K. Salahudeen, MD
• Esmeralda Salais
• Alex Peter Salakana
• Nathanael Salako
• Reinal R Salako
• Amir Qamrus Salam, M.D.
• Kassem Salam, MD
• Sana Salam, DMD, MS

• All providers in Houston, TX
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.