Individual provider Active NPI

Ebenezer Olubunmi Adebiyi, MD

  • Pediatric Cardiology Physician
  • San Antonio, TX
National Provider Identifier
1164058012
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
W5224 Issued in TX
Practice address
4499 Medical Dr Ste 289
San Antonio, TX 78229-3712
Phone
(210) 614-3264
Fax
(210) 615-0888
NPI assigned
Mar 22, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X W5224 TX Primary

Addresses

Primary practice location

4499 Medical Dr Ste 289
San Antonio, TX 78229-3712

Mailing address

4499 Medical Dr Ste 289
San Antonio, TX 78229-3712
Phone (210) 614-3264

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Pediatric Medicine
Education
Other, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2000 Health Park Dr
Brentwood, TN 37027-4692

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Physician Practices, PLLC CurrentSince Aug 1, 2026 Accepting new patients
Magella Medical Associates Billing, Inc. Pediatric Cardiology CurrentSince Aug 1, 2026 Accepting new patients

Locations

4499 Medical Dr
Ste 289
San Antonio, TX 78229
Phone (210) 614-3264

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16700/brand/2/csg/1/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1584835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1164058012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4499 MEDICAL DR STE 289",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293712",
            "telephone_number": "210-614-3264",
            "fax_number": "210-615-0888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4499 MEDICAL DR STE 289",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293712",
            "telephone_number": "210-614-3264",
            "fax_number": "210-615-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEBIYI",
        "first_name": "EBENEZER",
        "middle_name": "OLUBUNMI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-22",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "TX",
            "license": "W5224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.