NPIMap

Individual provider Active NPI

Adesola Adenegan, M.D

  • Interventional Cardiology Physician
  • San Antonio, TX
National Provider Identifier
1063875102
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
S4083 Issued in TX
Practice address
4411 Medical Dr Ste 300
San Antonio, TX 78229-3824
Phone
(210) 614-5400
Fax
(210) 614-2413
NPI assigned
Apr 5, 2016
Last updated
Jan 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Cardiovascular Disease Physician 207RC0000X S4083 TX
Interventional Cardiology Physician 207RI0011X S4083 TX Primary

Addresses

Primary practice location

4411 Medical Dr Ste 300
San Antonio, TX 78229-3824

Mailing address

5715 Rogers Rd Ste 115
San Antonio, TX 78251-3764
Phone (210) 614-5400

Other practice location 1

4800 Alberta Ave
El Paso, TX 79905-2709
Phone (915) 215-8000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230629001446 TX Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 3173857802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiology Clinic of San Antonio, PLLCGroup PAC ID 1153517420, 125 clinicians

Practice addresses (Care Compare)

4411 Medical Dr
Suite 300
San Antonio, TX 78229-3824
Phone (210) 614-5400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.32 of 100Reported as group
Quality
75.23
Promoting interoperability
99
Improvement activities
40
Cost
76.31

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S4083TXMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiology Clinic of San Antonio, PLLC Cardiovascular Disease CurrentSince Aug 1, 2023 Accepting new patients
San Antonio Cardiology Clinic PA Cardiovascular Disease Past Accepting new patients
Methodist Physician Practices, PLLC Cardiovascular Disease PastSince Feb 4, 2024 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

4411 Medical Dr
Ste 300
San Antonio, TX 78229
Phone (210) 582-5145

5715 Rogers Rd
Ste 115
San Antonio, TX 78251
Phone (210) 874-3640

Interoperability endpoints

  • Direct secure messaging: 3210-adenegan-adesola@direct.leadingreach.com
  • Direct secure messaging: adesola.adenegan@direct.myhealthep.org
  • Direct secure messaging: adesola.adenegan@hca7.eclinicaldirectplus.com
  • FHIR API: https://api.platform.athenahealth.com/16700/brand/2/csg/1/fhir/r4

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 7

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": "1459814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1063875102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5715 ROGERS RD STE 115",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782513764",
            "telephone_number": "210-614-5400",
            "fax_number": "210-614-2413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 MEDICAL DR STE 300",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293824",
            "telephone_number": "210-614-5400",
            "fax_number": "210-614-2413"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4800 Alberta Ave",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799052709",
            "country_code": "US",
            "telephone_number": "915-215-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADENEGAN",
        "first_name": "ADESOLA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-05",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "S4083",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "S4083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.