Ejodamen Blessing Shobowale, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

2288 Issued in TX

Practice address

15003 FM 529 Rd Ste B
Houston, TX 77095-4379

Phone

(832) 415-1790

Fax

(281) 619-7998

NPI assigned

Jun 27, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 8

Other names 1

• Ejodamen B Shobowale Professional name

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Houston Healthcare Kingwood Hospital, Kingwood, TX, CCN 450775

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• First Step Foot and Ankle Center

  • Foot & Ankle Surgery Podiatrist
  • Houston, TX
  • NPI 1982115259
  NPD (past)
• Preferred Podiatry Group PC

  • Podiatrist
  • Chicago, IL
  • NPI 1134576143
  NPD (past)

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

• KPH-Consolidation, Inc.

  • General Acute Care Hospital
  • Kingwood, TX
  • NPI 1811942238
  Care Compare affiliation

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

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    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1083029060",
    "addresses": [
        {
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            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15003 FM 529 RD",
            "city": "HOUSTON",
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            "postal_code": "770954375",
            "telephone_number": "832-819-3511",
            "fax_number": "281-619-7998"
        },
        {
            "country_code": "US",
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            "address_purpose": "LOCATION",
            "address_type": "DOM",
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            "postal_code": "770954379",
            "telephone_number": "832-415-1790",
            "fax_number": "281-619-7998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10655 Steepletop Dr",
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            "fax_number": "281-619-7998",
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        },
        {
            "address_1": "22999 Highway 59 N",
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        },
        {
            "address_1": "205 Hollow Tree Ln",
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            "country_code": "US",
            "telephone_number": "773-510-0124",
            "fax_number": "281-619-7998",
            "country_name": "United States",
            "address_type": "DOM"
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            "address_1": "1800 W 26th St",
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            "state": "TX",
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            "country_code": "US",
            "telephone_number": "773-510-0124",
            "fax_number": "281-619-7998",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11297 Fallbrook Dr",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770654230",
            "country_code": "US",
            "telephone_number": "773-510-0124",
            "fax_number": "281-619-7998",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1550 First Colony Blvd",
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            "city": "Sugar Land",
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            "postal_code": "774794000",
            "country_code": "US",
            "telephone_number": "773-510-0124",
            "fax_number": "281-619-7998",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11297 Fallbrook Dr",
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            "postal_code": "770654230",
            "country_code": "US",
            "telephone_number": "832-819-3511",
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            "country_name": "United States",
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        },
        {
            "address_1": "1550 First Colony Blvd",
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            "state": "TX",
            "postal_code": "774794000",
            "country_code": "US",
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            "fax_number": "281-619-7998",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22999 Highway 59 N",
            "address_purpose": "LOCATION",
            "city": "Kingwood",
            "state": "TX",
            "postal_code": "773394412",
            "country_code": "US",
            "telephone_number": "773-510-0124",
            "fax_number": "281-619-7998",
            "country_name": "United States",
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        },
        {
            "address_1": "22999 Highway 59 N",
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            "country_code": "US",
            "telephone_number": "281-348-8972",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "205 Hollow Tree Ln",
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            "country_name": "United States",
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        },
        {
            "address_1": "1800 W 26th St",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770081450",
            "country_code": "US",
            "telephone_number": "832-819-3511",
            "fax_number": "281-619-7998",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10655 Steepletop Dr",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770654222",
            "country_code": "US",
            "telephone_number": "832-819-3511",
            "fax_number": "281-619-7998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHOBOWALE",
        "first_name": "EJODAMEN",
        "middle_name": "BLESSING",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-27",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "2288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "375642104",
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        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "375642103",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "375642107",
            "state": "TX"
        },
        {
            "code": "01",
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            "issuer": "BCBS TX",
            "identifier": "003VAA",
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            "desc": "MEDICAID",
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            "desc": "MEDICAID",
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            "desc": "MEDICAID",
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            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "375642101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EJODAMEN",
            "last_name": "SHOBOWALE",
            "middle_name": "B",
            "credential": "DPM",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Ali Shoaee, DDS
• Catherine Shoaf, D.M.D.
• Oluwabukola Stephanie Shoaga, M.D.
• Arif M. Shoaib, M.D.
• Fisayomi Shobayo, MD
• Abigail Nichole Shockley, PHARMD
• Sherouk Shoeib, MBBCH
• Kelsie Anne Shoemake, PA-C
• Mary Katherine Shoemaker, MD
• Norman Alan Shoenfeld, M.D.

• Foot & Ankle Surgery Podiatrist in Houston, TX
• Providers in Houston, TX by specialty
• Foot & Ankle Surgery Podiatrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; 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.