Individual provider Active NPI

Oluwadamilola T Adeyeye

  • Physical Therapist
  • San Antonio, TX
National Provider Identifier
1700360781
Registry record updated Sep 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1310291 Issued in TX
Practice address
11219 Potranco Rd Ste 110
San Antonio, TX 78253-5849
Phone
(210) 892-0359
Fax
(210) 679-6904
NPI assigned
Sep 17, 2018
Last updated
Sep 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1310291 TX Primary

Addresses

Primary practice location

11219 Potranco Rd Ste 110
San Antonio, TX 78253-5849

Mailing address

11219 Potranco Rd Ste 110
San Antonio, TX 78253-5849
Phone (210) 892-0359

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181022000537 TX Practitioner - Physical Therapist in Private Practice 2264785278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.26 of 100Reported as group
Quality
89.74
Improvement activities
40
Cost
61.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Socialite PT PLLC Physical Therapist Current Accepting new patients
Texas Luna Care Physical Therapy LLC Physical Therapist CurrentSince Feb 15, 2023 Accepting new patients

Locations

5900 Balcones Dr
Ste 100
Austin, TX 78731

180 State St
Ste 225
Southlake, TX 76092
Phone (682) 429-7066

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1537142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537142400000",
    "number": "1700360781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11219 POTRANCO RD STE 110",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782535849",
            "telephone_number": "210-892-0359",
            "fax_number": "210-679-6904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11219 POTRANCO RD STE 110",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782535849",
            "telephone_number": "210-892-0359",
            "fax_number": "210-679-6904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEYEYE",
        "first_name": "OLUWADAMILOLA",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-17",
        "last_updated": "2018-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1310291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.