Adewale Adeyinka Odukoya, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

S5721 Issued in TX

Practice address

294 Summar Dr
Jackson, TN 38301-3915

Phone

(731) 423-1932

Fax

(731) 410-0367

NPI assigned

Mar 23, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 7

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, KY, MO, TX4 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 4

Specialty

Family Practice

Education

University of Tennessee, HSC, College of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Northeast Texas Emergency Physicians PLLCGroup PAC ID 8527420306, 195 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Texas Medical Center Hospital, Gainesville, TX, CCN 450090
• Navarro Regional Hospital Hospital, Corsicana, TX, CCN 450447
• Christus Mother Frances Hospital Sulphur Springs Hospital, Sulphur Springs, TX, CCN 450236
• Graham Regional Medical Center Hospital, Graham, TX, CCN 671300
• The Medical Center at Russellville Hospital, Russellville, KY, CCN 180066

Merit-based Incentive Payment System (MIPS)

Final score

90.94 of 100Reported as group

Quality

82.79

Improvement activities

40

Cost

76.18

Merit-based Incentive Payment System (MIPS)

Final score

99.43 of 100Reported as group

Quality

93.73

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations (25 of 43)

Interoperability endpoints

• Direct secure messaging: adewale.odukoya.1@6815.direct.athenahealth.com

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.

• Northeast Texas Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Longview, TX
  • NPI 1114607611
  Medicare reassignment Care Compare group NPD
• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382

  TN

  Medicare reassignment Care Compare group NPD
• App of Tennessee HM, PLLC

  • Hospitalist Physician
  • Shelbyville, TN
  • NPI 1396160768

  Emergency Medicine

  Medicare reassignment NPD
• Emergency Medical Care Facilities PC

  • Emergency Medicine Physician
  • Jackson, TN
  • NPI 1538345855
  Medicare reassignment NPD
• Southeastern Physician Services PC

  • Hospitalist Physician
  • Oak Ridge, TN
  • NPI 1083835441

  Internal Medicine, KY

  Medicare reassignment NPD
• Angelina Emergency Medicine Associates PA

  • Emergency Medicine Physician
  • Lufkin, TX
  • NPI 1518397298
  Medicare reassignment NPD
• Century Integrated Partners, Inc

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1447615711
  Medicare reassignment NPD
• Concord Medical Group of Texas PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1750790762
  Medicare reassignment NPD
• Concord Medical Group PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1083630610

  TN

  Medicare reassignment NPD
• Fep of Kentucky LLC

  • Emergency Medicine Physician
  • Hopkinsville, KY
  • NPI 1770266553
  Medicare reassignment NPD
• Hospitalist Medicine Physicians of Texas - Cypress PLLC

  • Internal Medicine Physician
  • Bonham, TX
  • NPI 1184458838
  Medicare reassignment NPD
• Kentucky Post-Acute Medical Services 1 PSC

  • Behavioral Neurology & Neuropsychiatry Physician
  • Flemingsburg, KY
  • NPI 1831628783
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bowling Green-Warren County Community Hospital Corporation

  • Rural Acute Care Hospital
  • Russellville, KY
  • NPI 1124868963
  Care Compare affiliation
• Christus Hopkins Health Alliance

  • General Acute Care Hospital
  • Sulphur Springs, TX
  • NPI 1033568621
  Care Compare affiliation
• Gainesville Community Hospital, Inc.

  • General Acute Care Hospital
  • Gainesville, TX
  • NPI 1972071991
  Care Compare affiliation
• Graham Hospital District

  • Critical Access Hospital
  • Graham, TX
  • NPI 1063113983
  Care Compare affiliation
• Navarro Hospital LP

  • General Acute Care Hospital
  • Corsicana, TX
  • NPI 1144274226
  Care Compare affiliation

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

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1902268550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "294 SUMMAR DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013915",
            "telephone_number": "731-423-1932",
            "fax_number": "731-410-0367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "294 SUMMAR DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013915",
            "telephone_number": "731-423-1932",
            "fax_number": "731-410-0367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODUKOYA",
        "first_name": "ADEWALE",
        "middle_name": "ADEYINKA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-23",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "56635",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "51712",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2020010832",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "56635",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "51712",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "TX",
            "license": "S5721",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "S5721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Emergency Medicine Physician in Jackson, TN
• Providers in Jackson, TN by specialty
• Emergency Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.