Ayotunde Gregory Faweya, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

P4646 Issued in TX

Practice address

15210 I-45 South
Suite 110
Conroe, TX 77384-4105

Phone

(936) 270-8655

Fax

(936) 270-8739

NPI assigned

Nov 30, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ayotunde.faweya.1@17406.direct.athenahealth.com
• FHIR API: https://fhir4.healow.com/fhir/r4/ECCJAD
• Direct secure messaging: charrison@mehop.directbygreenway.com

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.

• Matagorda Episcopal Health Outreach Program Corporation

  dba MEHOP Physician Group

  • Federally Qualified Health Center (FQHC)
  • Bay City, TX
  • NPI 1598024788
  Medicare reassignment NPD
• Matagorda Episcopal Health Outreach Program

  dba MEHOP Wharton Health 3

  • Federally Qualified Health Center (FQHC)
  • Wharton, TX
  • NPI 1205449386
  NPD
• Matagorda Episcopal Health Outreach Program

  dba Vibrance Health

  • Dentist
  • Bay City, TX
  • NPI 1073703575
  NPD (past)
• Matagorda Episcopal Health Outreach Program

  • Federally Qualified Health Center (FQHC)
  • Palacios, TX
  • NPI 1467009092
  NPD (past)
• Northside Pediatrics Associates, PA

  • Pediatrics Physician
  • Conroe, TX
  • NPI 1669928883
  NPD (past)

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

{
    "created_epoch": "1259539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1609104785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MEDICAL CENTER BLVD STE 350",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042878",
            "telephone_number": "936-270-8655",
            "fax_number": "936-270-8739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15210 I-45 SOUTH",
            "address_2": "SUITE 110",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773844105",
            "telephone_number": "936-270-8655",
            "fax_number": "936-270-8739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAWEYA",
        "first_name": "AYOTUNDE",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-30",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2009-01988",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "28250",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME111094",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P4646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danny Farley, M.D.
• Arnella Cleo Farmer, LVN
• Aalia Farukhi
• Markie Faulkner
• Naomi Ruth Fawcett
• Lea Fay
• Imran Fayaz, M.D.
• Madison Feaster, RNFA
• Patricia Lynn Feder, M.S., CCC-SLP
• Lauren Victoria Fell

• Pediatrics Physician in Conroe, TX
• Providers in Conroe, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.