NPIMap

Individual provider Active NPI

Oladunni Modupeola Adetoba, M.D

  • Internal Medicine Physician
  • Slidell, LA
National Provider Identifier
1679007736
Registry record updated Feb 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
323946 Issued in LA
Practice address
1001 Gause Blvd # 4
Slidell, LA 70458-2939
Phone
(985) 280-8743
Fax
(985) 280-8554
NPI assigned
Apr 16, 2017
Last updated
Feb 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X 323946 LA Primary

Addresses

Primary practice location

1001 Gause Blvd # 4
Slidell, LA 70458-2939

Mailing address

1001 Gause Blvd # 4
Slidell, LA 70458-2939
Phone (985) 280-8743

Other practice location 1

625 19th St S
Birmingham, AL 35233-1900
Phone (334) 874-3463

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201019000303 LA Practitioner - Internal Medicine 7012283062 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apogee Medical Group, Louisiana, Inc.Group PAC ID 8527116193, 31 clinicians
Ochsner Clinic LLCGroup PAC ID 8224933619, 2,845 clinicians

Practice addresses (Care Compare)

1001 Gause Blvd
Slidell, LA 70458-2939
Phone (985) 280-8743

111 C Robert E Lee Blvd
New Orleans, LA 70124-2534
Phone (504) 286-2004

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.07 of 100Reported as group
Quality
75.45
Improvement activities
40
Cost
83.37

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC Internal Medicine CurrentSince Nov 17, 2025 Accepting new patients
Ochsner Clinic LLC Internal Medicine CurrentSince Nov 17, 2025 Accepting new patients
Ochsner Clinic LLC Current Accepting new patients
Apogee Medical Group, Louisiana, Inc. CurrentSince Sep 7, 2020 Accepting new patients
Ochsner Clinic LLC Family Medicine Past Accepting new patients
University Healthcare System, L.C. Past Accepting new patients
Slidell Memorial Hospital Internal Medicine PastSince Feb 14, 2021 Accepting new patients

Locations

1111 Greengate Dr
Ste B
Covington, LA 70433
Phone (985) 246-2420

95 Judge Tanner Blvd
Covington, LA 70433
Phone (504) 867-3800

5922 W Main St
Ste A
Houma, LA 70360
Phone (985) 262-8015

3417 Williams Blvd
Kenner, LA 70065
Phone (504) 461-9660

12895 Highway 90
Ste H
Luling, LA 70070
Phone (985) 331-9400

2215 Veterans Memorial Blvd
Metairie, LA 70002
Phone (504) 838-3524

4100 Canal St
New Orleans, LA 70119
Phone (504) 703-2750

4605 Magazine St
New Orleans, LA 70115
Phone (504) 883-8111

900 Magazine St
New Orleans, LA 70130
Phone (504) 309-0534

9605 Jefferson Hwy
River Ridge, LA 70123
Phone (504) 738-1604

1001 Gause Blvd
Slidell, LA 70458
Phone (985) 280-2200

1001 Gause Blvd
#4
Slidell, LA 70458
Phone (985) 280-8743

Interoperability endpoints

  • Direct secure messaging: oadetoba930879@direct.ochsner.org

Organizations & group practices 7

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 10

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": "1492300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1679007736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 GAUSE BLVD # 4",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704582939",
            "telephone_number": "985-280-8743",
            "fax_number": "985-280-8554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 GAUSE BLVD # 4",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704582939",
            "telephone_number": "985-280-8743",
            "fax_number": "985-280-8554"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 19th St S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352331900",
            "country_code": "US",
            "telephone_number": "334-874-3463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADETOBA",
        "first_name": "OLADUNNI",
        "middle_name": "MODUPEOLA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-16",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "323946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

Verify at the official NPI Registry.