Individual provider Active NPI

Olabode C. Ogunwole, M.D.

  • Anesthesiology Physician
  • San Antonio, TX
National Provider Identifier
1871858092
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
P9672 Issued in TX
Practice address
4502 Medical Dr
San Antonio, TX 78229-4402
Phone
(210) 567-4506
NPI assigned
Jul 13, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X D90619 MD
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X P9672 TX Primary

Addresses

Primary practice location

4502 Medical Dr
San Antonio, TX 78229-4402

Mailing address

45 NE Loop 410
Ste 900
San Antonio, TX 78216-5831
Phone (210) 375-7790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MD, DC3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20160511000167 TX Practitioner - Anesthesiology 4284923566 Reassigns benefits to 1 organization
I20210317002261 MD Practitioner - Anesthesiology 4284923566 Reassigns benefits to 3 organizations
I20210317002546 DC Practitioner - Anesthesiology 4284923566 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meritus Medical Center IncGroup PAC ID 7113811795, 730 clinicians
Anesthesia Company LLCGroup PAC ID 4587559026, 373 clinicians
First Colonies Anesthesia Associates, LLCGroup PAC ID 8426039744, 339 clinicians

Practice addresses (Care Compare)

11116 Medical Campus Rd
Hagerstown, MD 21742-6710
Phone (301) 790-9044

400 W 7TH St
Frederick, MD 21701-4506
Phone (240) 566-3300

70 Sherry LN
Suite 101
Prince Frederick, MD 20678-3276
Phone (410) 889-2040

8600 Old Georgetown Rd
Bethesda, MD 20814-1422
Phone (301) 896-3931

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
63.85 of 100Reported as group
Quality
57.47
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D90619MDMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northrium Health LLC Anesthesiology CurrentSince Aug 1, 2025 Accepting new patients
Meritus Medical Center Inc CurrentSince Oct 1, 2025 Accepting new patients
Meritus Medical Center Inc CurrentSince Oct 1, 2025 Accepting new patients
Tejas Anesthesia PLLC Anesthesiology CurrentSince May 20, 2017 Accepting new patients
Anesthesia Company, LLC Anesthesiology CurrentSince Dec 15, 2024 Accepting new patients
Tejas Anesthesia PLLC Anesthesiology CurrentSince May 20, 2017 Accepting new patients
First Colonies Anesthesia Associates, LLC Anesthesiology CurrentSince Mar 15, 2021 Accepting new patients
Meritus Medical Center Inc Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

851 Trafalgar Ct
Ste 200E
Maitland, FL 32751
Phone (321) 422-7155

2001 Medical Pkwy
Annapolis, MD 21401
Phone (410) 280-5601

8600 Old Georgetown Rd
Bethesda, MD 20814
Phone (301) 896-2578

8222 Schultz Rd
Clinton, MD 20735
Phone (202) 600-5683

400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300

11116 Medical Campus Rd
Hagerstown, MD 21742
Phone (301) 766-7600

70 Sherry Ln
Ste 101
Prnc Frederck, MD 20678
Phone (410) 889-2040

11210 Old Georgetown Rd
#12202
Rockville, MD 20852
Phone (301) 881-7770

11210 Old Georgetown Rd
Rockville, MD 20852
Phone (301) 881-7770

8322 Bellona Ave
Ste 201
Towson, MD 21204
Phone (410) 337-2688

2240 Gulf Fwy S
League City, TX 77573
Phone (832) 505-1000

4242 Medical Dr
Ste 3100
San Antonio, TX 78229
Phone (210) 477-9555

4242 Medical Dr
Ste 1260
San Antonio, TX 78229
Phone (210) 477-9551

4502 Medical Dr
San Antonio, TX 78229
Phone (210) 358-3555

Interoperability endpoints

  • Direct secure messaging: oogunwole880575@direct.umm.edu

Organizations & group practices 9

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.

Hospital & facility affiliations 5

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": "1342137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1871858092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 NE LOOP 410",
            "address_2": "STE 900",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782165831",
            "telephone_number": "210-375-7790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-567-4506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUNWOLE",
        "first_name": "OLABODE",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-13",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MD",
            "license": "D90619",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "P9672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.