Individual provider Active NPI

Abumere Folashade Akinwale, MD

  • Retina Specialist (Ophthalmology) Physician
  • San Antonio, TX
National Provider Identifier
1083871818
Registry record updated Nov 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
R4507 Issued in TX
Practice address
8410 Datapoint Dr
San Antonio, TX 78229
Phone
(210) 949-9733
Fax
(210) 949-8925
NPI assigned
May 20, 2008
Last updated
Nov 12, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2018

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 22016 MS
Ophthalmology Physician 207W00000X R4507 TX
Ophthalmology Physician 207W00000X 232032 MA
Retina Specialist (Ophthalmology) Physician 207WX0107X 22016 MS
Retina Specialist (Ophthalmology) Physician 207WX0107X R4507 TX Primary

Addresses

Primary practice location

8410 Datapoint Dr
San Antonio, TX 78229

Mailing address

8410 Datapoint Dr
San Antonio, TX 78229-3220
Phone (210) 949-9733

Other practice location 1

17319 Ih 35 N Ste 303
Schertz, TX 78154-1282
Phone (830) 214-2704

Other identifiers 1

IdentifierTypeStateIssuer
01875525MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20120718000657 MS Practitioner - Ophthalmology 3476719543 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
232032MAMDOphthalmology Physician
22016MSMDRetina Specialist (Ophthalmology) Physician
R4507TXMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Eye Physicians Center, LLC Ophthalmology CurrentSince Aug 1, 2012 Accepting new patients
Retina Consultants of Houston PLLC Ophthalmology PastSince Nov 1, 2018 Accepting new patients

Locations

1420 S 28th Ave
Hattiesburg, MS 39402
Phone (601) 264-3937

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541980800000",
    "number": "1083871818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8410 DATAPOINT DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293220",
            "telephone_number": "210-949-9733",
            "fax_number": "210-949-8925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8410 DATAPOINT DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78229",
            "telephone_number": "210-949-9733",
            "fax_number": "210-949-8925"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17319 Ih 35 N Ste 303",
            "address_purpose": "LOCATION",
            "city": "Schertz",
            "state": "TX",
            "postal_code": "781541282",
            "country_code": "US",
            "telephone_number": "830-214-2704",
            "fax_number": "830-214-2718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AKINWALE",
        "first_name": "ABUMERE",
        "middle_name": "FOLASHADE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-20",
        "last_updated": "2018-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MS",
            "license": "22016",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "R4507",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "232032",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "MS",
            "license": "22016",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "TX",
            "license": "R4507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01875525",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.