NPIMap

Individual provider Active NPI

Iyobosasere Ighoroje, AGACNP

  • Acute Care Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1255930558
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP1016149 Issued in TX
Practice address
4502 Medical Dr
San Antonio, TX 78229-4402
Phone
(210) 358-4000
NPI assigned
Oct 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X AP1016149 TX Primary

Addresses

Primary practice location

4502 Medical Dr
San Antonio, TX 78229-4402

Mailing address

4502 Medical Dr
San Antonio, TX 78229-4402
Phone (210) 358-4000

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
I20210218000180 TX Practitioner - Nurse Practitioner 5890100135 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inpatient Progressive Health of America, PLLCGroup PAC ID 5698072320, 72 clinicians
Hospital Medicine Services of TX, PLLCGroup PAC ID 3274998067, 376 clinicians

Practice addresses (Care Compare)

16620 San Pedro Ave
Suite 300
San Antonio, TX 78232-2679
Phone (210) 871-4701

6700 W Ih
Suite 10
San Antonio, TX 78201-2009
Phone (210) 736-6700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP1016149TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Health Science Center at San Antonio CurrentSince Feb 8, 2021 Accepting new patients
University of Texas Health Science Center at San Antonio Current Accepting new patients
Hospital Medicine Services of TX, PLLC CurrentSince Mar 1, 2025 Accepting new patients
Inpatient Progressive Health of America, PLLC CurrentSince Dec 1, 2025 Accepting new patients
The University of Texas Health Science Center at San Antonio CurrentSince Feb 8, 2021 Accepting new patients

Locations

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

12141 Richmond Ave
Houston, TX 77082
Phone (281) 558-3444

11100 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 770-7000

6700 W Interstate 10
San Antonio, TX 78201
Phone (210) 575-8289

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

8311 Ewing Halsell Dr
San Antonio, TX 78229
Phone (210) 562-8000

16620 San Pedro Ave
Ste 300
San Antonio, TX 78232
Phone (210) 614-1231

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

11212 State Highway 151
San Antonio, TX 78251
Phone (210) 281-5066

4502 Medical Dr
San Antonio, TX 78229
Phone (210) 358-3555

Interoperability endpoints

  • Direct secure messaging: iighoroje65905@direct.utmsa.com

Organizations & group practices 5

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 6

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": "1603065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1255930558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-358-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-358-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IGHOROJE",
        "first_name": "IYOBOSASERE",
        "name_prefix": "Mrs.",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-19",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP1016149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.