SAMUEL O TENIOLA (MD) – Internal Medicine Physician, NPI 1518965938

SAMUEL O TENIOLA (MD) is a healthcare provider. based in Atlanta, Georgia. specializing in INTERNAL MEDICINE. They hold the professional credentials MD. They hold a License No. 049349 (GA). The NPI Number for SAMUEL O TENIOLA (MD) is 1518965938

Main info

Male
47 Years Of Experience
Accepts Medicare Assignment
Name
SAMUEL O TENIOLA (MD)
NPI
1518965938
Phone
(404) 524-8950
Address
285 BOULEVARD NE
Enumeration Date
10 July 2005
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7708977874
Graduation Year
1979 (47 years ago)
PAC ID
3779511514
Group Practice PAC ID
9032491956
Professional Enrollment ID
I20050802000591
Address ID
GA302742615RI11XXXSWXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

5,409 INTERNAL MEDICINE in GA

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Provider Addresses for SAMUEL O TENIOLA (MD)

  • Boulevard Northeast, Atlanta, Georgia, 30308, United States

    SUITE 435

    ATLANTA, GA 303124205

    Phone: (404) 524-8950

    Type: Location

  • 945 LINSLEY WAY

    STONE MOUNTAIN, GA 300876083

    Phone: (770) 879-9659

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-08-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050802000591IInternal MedicineGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30312)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9032491956View full group profile
NameSpecialtyState
-GA
Internal MedicineGA
General SurgeryKY
General SurgeryGA
General SurgeryTX
Family PracticeGA
Family PracticeGA
Internal Medicine, Emergency MedicineGA
Internal MedicineMA
-GA

Reviews

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Frequently asked questions

What is the standard ID for SAMUEL O TENIOLA (MD) in the U.S.?
In the U.S., SAMUEL O TENIOLA (MD) is identified by NPI 1518965938.
Quick check: is SAMUEL O TENIOLA (MD) active?
Public NPPES data shows SAMUEL O TENIOLA (MD) with an active NPI status right now.
Which specialty label fits SAMUEL O TENIOLA (MD)?
NPPES ties SAMUEL O TENIOLA (MD) to Internal Medicine Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is SAMUEL O TENIOLA (MD) tied to Atlanta, Georgia?
If you are local to Atlanta, Georgia, SAMUEL O TENIOLA (MD) may be relevant to your search.
Can I export SAMUEL O TENIOLA (MD)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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