Individual provider Active NPI

Abidemi Yemisi Adeniran, FNP

  • Family Nurse Practitioner
  • Odessa, TX
National Provider Identifier
1043085475
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F10230251 Issued in TX
Practice address
500 W 4TH St
Odessa, TX 79761-5001
Phone
(432) 640-2401
Fax
(432) 640-4778
NPI assigned
Nov 15, 2023
Last updated
Jun 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F10230251 TX Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2025096928 TX

Addresses

Primary practice location

500 W 4TH St
Odessa, TX 79761-5001

Mailing address

PO Box 2129
Odessa, TX 79760-2129
Phone (432) 640-2401

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20231121003048 TX Practitioner - Nurse Practitioner 4183072663 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCH Professional Care Hospital BasedGroup PAC ID 1557535127, 81 clinicians

Practice addresses (Care Compare)

500 W 4TH St
Odessa, TX 79761-5001
Phone (432) 640-2401

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.41 of 100Reported as group
Quality
72.52
Improvement activities
40
Cost
81.49

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F10230251TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Scotty Ortega MD LLP CurrentSince Oct 31, 2025 Accepting new patients
MCH Professional Care Hospital Based CurrentSince Nov 1, 2023 Accepting new patients

Locations

2487 E 11th St
Odessa, TX 79761
Phone (432) 332-1386

3001 N Faudree Rd
Odessa, TX 79765
Phone (432) 332-1386

500 W 4th St
Odessa, TX 79761
Phone (432) 640-1000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IEFJBD/Endpoint/IEFJBD

Organizations & group practices 3

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1700006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1043085475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2129",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797602129",
            "telephone_number": "432-640-2401",
            "fax_number": "432-640-4778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W 4TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615001",
            "telephone_number": "432-640-2401",
            "fax_number": "432-640-4778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADENIRAN",
        "first_name": "ABIDEMI",
        "middle_name": "YEMISI",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-15",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "F10230251",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "2025096928",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.