NPIMap

Individual provider Active NPI

Adekunle Adedayo Adedeji, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • El Paso, TX
National Provider Identifier
1902086937
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
N3416 Issued in TX
Practice address
8623 N Loop Dr Ste a
El Paso, TX 79907-4520
Phone
(915) 881-4155
Fax
(915) 881-4172
NPI assigned
Nov 7, 2007
Last updated
May 28, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X N3416 TX
Geriatric Medicine (Family Medicine) Physician 207QG0300X N3416 TX Primary

Addresses

Primary practice location

8623 N Loop Dr Ste a
El Paso, TX 79907-4520

Mailing address

8623 N Loop Dr Ste a
El Paso, TX 79907-4520
Phone (915) 881-4155

Other identifiers 3

IdentifierTypeStateIssuer
TXB158260OtherTXMEDICARE PTAN
2100976-03OtherTXWELLMED MEDICAID
TXB116628OtherTXWELLMED MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NM2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091020000378 TX Practitioner - Family Practice 4486791753 Reassigns benefits to 4 organizations
I20240626003772 NM Practitioner - Family PracticePractitioner - Geriatric Medicine 4486791753 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical School at San Antonio, 2009
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Socorro Medical Clinic LLCGroup PAC ID 3577862093, 4 clinicians
Medimount Clinic PLLCGroup PAC ID 3173986924, 3 clinicians
Kingsway Medical Center, PLLCGroup PAC ID 5092961839, 2 clinicians

Practice addresses (Care Compare)

1030 N Zaragoza Rd
Suite X
El Paso, TX 79907-1862

10720 N Loop Dr a
Socorro, TX 79927-4409
Phone (915) 351-4010

7470 Cimarron PLZ
Suite 300
El Paso, TX 79911-2220
Phone (915) 307-7800

8623 N Loop Dr
Suite a
El Paso, TX 79907-4520
Phone 9158814155103

992 S Broadway St
New Mexico State Veterans Home
Truth Or Consequences, NM 87901-3198
Phone (915) 881-4155

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N3416TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kingsway Medical Center PLLC Family Medicine CurrentSince Jul 19, 2012 Accepting new patients
Dominion Medical Services, PLLC Family Medicine CurrentSince Sep 8, 2015 Accepting new patients
Socorro Medical Clinic LLC Family Medicine CurrentSince Mar 27, 2016 Accepting new patients
Medimount Clinic PLLC CurrentSince Jan 1, 2024 Accepting new patients
Delight Healthcare Solutions LLC Past Accepting new patients
Frio Hospital District Past Accepting new patients
The Evangelical Lutheran Good Samaritan Society Past Accepting new patients
Socorro Health Care, LLC Past Accepting new patients
State of New Mexico Past Accepting new patients

Locations

992 S Broadway St
Truth Or Consequences, NM 87901
Phone (575) 894-4200

1030 N Zaragoza Rd
Ste X
El Paso, TX 79907
Phone (915) 881-4155

10720 N Loop Dr
Ste A
Socorro, TX 79927
Phone (915) 351-4010

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10509/brand/1/csg/1/fhir/r4

Organizations & group practices 10

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": "1194393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1902086937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8623 N LOOP DR STE A",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799074520",
            "telephone_number": "915-881-4155",
            "fax_number": "915-881-4172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8623 N LOOP DR STE A",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799074520",
            "telephone_number": "915-881-4155",
            "fax_number": "915-881-4172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEDEJI",
        "first_name": "ADEKUNLE",
        "middle_name": "ADEDAYO",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-07",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N3416",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "TX",
            "license": "N3416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "TXB158260",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMED MEDICAID",
            "identifier": "2100976-03",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMED MEDICARE",
            "identifier": "TXB116628",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.