Adeniyi Olawale Igun, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

P3733 Issued in TX

Practice address

11345 Alamo Ranch Pkwy
Ste. 202
San Antonio, TX 78253-6440

Phone

(210) 688-9190

Fax

(877) 936-8202

NPI assigned

Apr 29, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

University of Texas Medical School at San Antonio, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Primway Medical, PLLC

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1699163923
  Medicare reassignment Authorized official
• Primway Dental, PLLC

  • Dental Clinic/Center
  • San Antonio, TX
  • NPI 1457995078
  NPD

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1285809251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11345 ALAMO RANCH PKWY",
            "address_2": "STE. 202",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782536440",
            "telephone_number": "210-688-9190",
            "fax_number": "855-744-6297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11345 ALAMO RANCH PKWY",
            "address_2": "STE. 202",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782536440",
            "telephone_number": "210-688-9190",
            "fax_number": "877-936-8202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IGUN",
        "first_name": "ADENIYI",
        "middle_name": "OLAWALE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-29",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "FI3546883",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "P3733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "athenahealth",
            "affiliation": "N",
            "address_1": "11345 Alamo Ranch Pkwy",
            "address_2": "Ste. 202",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782536440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mannhu Bui Iglesias, DDS
• Patricia Liz Iglesias
• Cherrish Ignacio
• Emmylou Tiamsim Ignacio
• Ignite Medical Resort San Antonio LLC
• Adepeju Olubukola Igun, DDS
• Olayinka Oluwayemisi Igun, DDS
• Ihcs Residential, Inc.
• Lilian Nkechinyere Iheanacho
• Angela Ihenacho

• Internal Medicine Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; 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.