Individual provider Active NPI

Sunday Abiodun Agboola, M.D

  • Hospitalist Physician
  • Fort Worth, TX
National Provider Identifier
1669603031
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
Q7996 Issued in TX
Practice address
11801 South Fwy
Texas Health Hugely Hospital
Fort Worth, TX 76028
Phone
(817) 293-9110
NPI assigned
Aug 4, 2009
Last updated
Mar 9, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MT195212 PA
Internal Medicine Physician 207R00000X MD446105 PA
Internal Medicine Physician 207R00000X Q7996 TX
Hospitalist Physician 208M00000X Q7996 TX Primary

Addresses

Primary practice location

11801 South Fwy
Texas Health Hugely Hospital
Fort Worth, TX 76028

Mailing address

3451 River Park Dr
Fort Worth, TX 76116-9575

Other practice location 1

2201 Clear Creek Rd
Killeen, TX 76549-4110
Phone (254) 526-7523

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sagboola788313@direct.sw.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120824000253 PA Practitioner - Internal Medicine 9638326739 Reassigns benefits to 1 organization
I20160811001113 TX Practitioner - Internal MedicinePractitioner - Hospitalist 9638326739 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

1605 S 31St St
Baylor Scott and White Center for Dia
Temple, TX 76508-0001
Phone (254) 215-0100

2401 S 31 St
Temple, TX 76508-0001
Phone (254) 724-2459

2401 S 31St St BLDG
35 Baylor Scott and White Roney Bone and
Temple, TX 76508-0001
Phone (254) 724-2663

810 W U Ave
Temple, TX 76508-0001
Phone (254) 724-2585

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD446105PAMDInternal Medicine Physician
Q7996TXMDHospitalist Physician
MT195212PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic Internal Medicine Current Accepting new patients
Christus Trinity Clinic Texas Internal Medicine CurrentSince Sep 11, 2020 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Internal Medicine CurrentSince Jul 5, 2016 Accepting new patients
Scott & White Clinic Internal Medicine CurrentSince Dec 21, 2020 Accepting new patients
Excela Health Physician Practices, Inc. CurrentSince Jun 3, 2019 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Sep 11, 2020 Accepting new patients
Excela Health Physician Practices, Inc Current Accepting new patients
Scott and White Clinic Internal Medicine CurrentSince Dec 21, 2020 Accepting new patients
Cogent Healthcare of Texas, PA Internal Medicine CurrentSince Dec 1, 2022 Accepting new patients
Scott & White Memorial Hospital Past Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients

Locations

532 W Pittsburgh St
Greensburg, PA 15601
Phone (724) 832-4000

11801 South Fwy
#I35W
Burleson, TX 76028
Phone (817) 293-4304

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

3201 W State Highway 22
Corsicana, TX 75110
Phone (903) 654-6800

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

2201 Clear Creek Rd
Killeen, TX 76549
Phone (254) 519-8185

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • Direct secure messaging: sagbolla59065@direct-guthrie.org
  • Direct secure messaging: sagboola@direct.excelahealth.org
  • Direct secure messaging: sagboola245449@christushealth.direct-ci.net
  • Direct secure messaging: sagboola788313@direct.sw.org

Organizations & group practices 11

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 2

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": "1249344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1669603031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3451 RIVER PARK DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761169575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11801 SOUTH FWY",
            "address_2": "TEXAS HEALTH HUGELY HOSPITAL",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76028",
            "telephone_number": "817-293-9110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2201 Clear Creek Rd",
            "address_purpose": "LOCATION",
            "city": "Killeen",
            "state": "TX",
            "postal_code": "765494110",
            "country_code": "US",
            "telephone_number": "254-526-7523",
            "fax_number": "254-724-8572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGBOOLA",
        "first_name": "SUNDAY",
        "middle_name": "ABIODUN",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-04",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT195212",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD446105",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "Q7996",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "Q7996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sagboola788313@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2201 Clear Creek Rd",
            "city": "Killeen",
            "state": "TX",
            "country_code": "US",
            "postal_code": "765494110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.