NPIMap

Individual provider Active NPI

Adetayo Richard Ademuyiwa, M.D.

  • Pulmonary Disease Physician
  • Saint Louis, MO
National Provider Identifier
1407944911
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
C186469 Issued in CA
Practice address
10651
St Louis, MO 63141
Phone
(636) 999-9999
NPI assigned
Oct 10, 2006
Last updated
Jan 30, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X C186469 CA Primary

Addresses

Primary practice location

10651
St Louis, MO 63141

Mailing address

10651
St Louis, MO 63141-4158

Other practice location 1

232 Hospital Dr Ste A
Ukiah, CA 95482-4562
Phone (707) 467-3189

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, CA, OH, WI4 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20111115000028 MO Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 8022033802 Reassigns benefits to 1 organization
I20230726003112 CA Practitioner - Pulmonary Disease 8022033802 Reassigns benefits to 1 organization
I20240611003498 OH Practitioner - Pulmonary Disease 8022033802 Reassigns benefits to 1 organization
I20251015000661 WI Practitioner - Pulmonary Disease 8022033802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

232 Hospital Dr
Suite a
Ukiah, CA 95482-4562
Phone (707) 467-3189

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.74 of 100Reported as group
Quality
94
Promoting interoperability
92
Improvement activities
40
Cost
65.12

Merit-based Incentive Payment System (MIPS)

Final score
95.77 of 100Reported as apm
Quality
81.54
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
80.98 of 100Reported as group
Quality
73.31
Promoting interoperability
92
Improvement activities
40
Cost
62

Merit-based Incentive Payment System (MIPS)

Final score
89.41 of 100Reported as group
Quality
86.32
Promoting interoperability
95
Improvement activities
40
Cost
66.55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C186469CAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alteas Health Pulmonary of Wisconsin S.C. Pulmonary Disease CurrentSince Aug 4, 2025 Accepting new patients
Adventist Health Physicians Network Current Accepting new patients
Adventist Health Physicians Network CurrentSince Jul 24, 2023 Accepting new patients
Crystal City Pulmonary Critical Care & Sleep Medicine Pulmonary Disease Current Accepting new patients
Adventist Health Physicians Network CurrentSince Jul 24, 2023 Accepting new patients
Critical Care Pulmonary & Sleep Medicine Assoc LLC Pulmonary Disease CurrentSince Nov 1, 2011 Accepting new patients
Alteas Health Pulmonary Indiana PC Pulmonary Disease Past Accepting new patients
Pulmonary Group of Western New York, LLP Pulmonary Disease PastSince Jul 1, 1993 Accepting new patients
Jefferson Memorial Hospital Association Past Accepting new patients
Ozarks Medical Center Past Accepting new patients
Parkland Health Center Internal Medicine Past Accepting new patients
Rpci Oncology PC Internal Medicine Past Accepting new patients

Locations

15322 Lakeshore Dr
Ste 102
Clearlake, CA 95422
Phone (707) 994-2030

232 Hospital Dr
Ste A
Ukiah, CA 95482
Phone (707) 463-2121

7245 Raider Rd
Ste D
Bonne Terre, MO 63628

1390 US Highway 61
Ste 2300
Crystal Cty, MO 63028
Phone (314) 996-7190

1400 US Highway 61
Crystal Cty, MO 63028
Phone (636) 933-1111

1455 US Highway 61
Ste C
Crystal Cty, MO 63028
Phone (636) 937-1528

301 S Bedford St
Ste 1
Madison, WI 53703
Phone (773) 766-9444

33 E Main St
Ste 610
Madison, WI 53703

Interoperability endpoints

  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 13

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.

View all 13

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1407944911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10651",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "631414158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10651",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63141",
            "telephone_number": "636-999-9999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "232 Hospital Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Ukiah",
            "state": "CA",
            "postal_code": "954824562",
            "country_code": "US",
            "telephone_number": "707-467-3189",
            "fax_number": "707-462-0123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADEMUYIWA",
        "first_name": "ADETAYO",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "C186469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.