Active NPI
Abumere Folashade Akinwale, MD
- Retina Specialist (Ophthalmology) Physician
- San Antonio, TX
National Provider Identifier
1083871818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Retina Specialist (Ophthalmology) Physician
- License
- R4507
- 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, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01875525 | Medicaid | MS |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 232032 | MA | MD | Ophthalmology Physician |
| 22016 | MS | MD | Retina Specialist (Ophthalmology) Physician |
| R4507 | TX | MD | Retina Specialist (Ophthalmology) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern Eye Physicians Center, LLC | Ophthalmology | Current | Accepting new patients |
| Retina Consultants of Houston PLLC | Ophthalmology | Past | 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.
-
dba Southern Eye Center
- Ophthalmology Physician
- Hattiesburg, MS
- NPI 1235316266
-
dba Retina Consultants of Texas
- Retina Specialist (Ophthalmology) Physician
- Beaumont, TX
- NPI 1720758709
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2018; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.