Individual provider Active NPI

James Oyetunde Oyekan, MD

  • Gynecology Physician
  • Jbsa, Fort Sam Houston, TX
National Provider Identifier
1053499368
Registry record updated Oct 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
25MA07947500 Issued in NJ
Practice address
3551 Roger Brooke Dr
Dept OB/GYN
Jbsa, Fort Sam Houston, TX 78253
Phone
(210) 221-0938
NPI assigned
Nov 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician 2088F0040X 0101253319 VA
Gynecology Physician 207VG0400X 25MA07947500 NJ Primary

Addresses

Primary practice location

3551 Roger Brooke Dr
Dept OB/GYN
Jbsa, Fort Sam Houston, TX 78253

Mailing address

411 Eissman Rd
At 6
Leesville, LA 71446-5430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260519001567 MN Practitioner - Obstetrics/Gynecology 9234283417 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1406 6TH Ave N
Saint Cloud, MN 56303-1900

525 Main St W
Melrose, MN 56352-1043

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA07947500NJMDGynecology Physician

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1053499368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 EISSMAN RD",
            "address_2": "AT 6",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714465430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "address_2": "DEPT OB/GYN",
            "city": "JBSA, FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "78253",
            "telephone_number": "210-221-0938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OYEKAN",
        "first_name": "JAMES",
        "middle_name": "OYETUNDE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2021-10-04",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2088F0040X",
            "taxonomy_group": "",
            "desc": "Urology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "VA",
            "license": "0101253319",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NJ",
            "license": "25MA07947500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jbsa, Fort Sam Houston, TX

Sources for this page

Verify at the official NPI Registry.