Oladipo A Adeniyi, MD
Individual provider Active NPI Nephrology Physician · Gallup, NM
NPI 1497733810 · NPPES record last updated Jan 5, 2009
Key facts
- NPI
- 1497733810
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nephrology Physician 207RN0300X
- License
- 2002-0397 (NM)
- Practice address
- 1801 Redrock Dr
Gallup, NM 87301-5655 - Phone
- (505) 863-7993
- Fax
- (505) 863-9406
- NPI assigned
- Jan 5, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Nephrology
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- High Desert Nephrology Associates PLLC
Rehoboth McKinley Christian Health Care Services, Inc.
Practice addresses (Care Compare)
1551 S 2ND St
Gallup, NM 87301-5881
Phone (505) 863-7993
1901 Red Rock Dr
Gallup, NM 87301-5683
Phone (505) 863-7000
Hospital & facility affiliations
- Usrc Gallup Dialysis
- Usrc Gallup Home
- 322510 Grants Dialysis (Dci)
- 322524 Acl Dialysis (Dci)
- Rehoboth McKinley Christian Health Care Services
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040526001641 | NM | Practitioner - Nephrology | 5799766630 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2002-0397 | NM | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cibola General Hospital Corporation | Nephrology | Current |
Accepting new patients |
| High Desert Nephrology Associates PLLC | Nephrology | Current |
Accepting new patients |
| Renal Medicine Associates LTD. | Current |
Accepting new patients | |
| Rehoboth McKinley Christian Health Care Services, Inc | Current |
Accepting new patients | |
| Rehoboth McKinley Christian Health Care Services, Inc | Current |
Accepting new patients | |
| Rehoboth McKinley Christian Health Care Services, Inc. | Current | Accepting new patients | |
| Red Rocks Dialysis, LLC | Past |
Accepting new patients |
Locations
3821 Masthead St NE
Albuquerque, NM 87109
Phone (505) 998-7400
1551 S Second St
Gallup, NM 87301
Phone (505) 542-0090
1801 Red Rock Dr
Gallup, NM 87301
Phone (505) 863-7933
2111 College Dr
Gallup, NM 87301
Phone (505) 397-5172
1900 Red Rock Dr
Gallup, NM 87301
Phone (505) 863-1820
1901 Red Rock Dr
Gallup, NM 87301
Phone (505) 863-7000
1423 E Roosevelt Ave
Grants, NM 87020
Phone (505) 287-6500
1016 E Roosevelt Ave
Grants, NM 87020
Phone (505) 287-4446
313 W Country Club Rd
Ste 12
Roswell, NM 88201
Phone (505) 627-5828
Interoperability endpoints
- oadeniyi72390@direct.acumenmd.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 2002-0397 | NM | Yes |
Addresses
Primary practice location
1801 Redrock Dr
Gallup, NM 87301-5655
Mailing address
1801 Redrock Dr
Gallup, NM 87301-5655
Phone (505) 863-7993
Other providers in Gallup, NM
- Victor Abramsky
- Jody Marie Acord
- Gianinna Karinell Acosta
- Robin Acothley
- Ashley Addington
- Micki Lynn Adkins
- Shoghi Arrey Agbortoko
- Joshua Aggson
- Carmelita Agodon
- Calandra Ahasteen
All providers in Gallup, NM · Nephrology Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 5, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.