ADETOMIWA OGUNDERE (M.D.) – Internal Medicine Physician, NPI 1003227745

ADETOMIWA OGUNDERE (M.D.) is a healthcare provider. based in Odessa, Texas. specializing in FAMILY PRACTICE. They hold the professional credentials M.D.. They hold a License No. R8447 (TX). The NPI Number for ADETOMIWA OGUNDERE (M.D.) is 1003227745

Main info

Male
12 Years Of Experience
Accepts Medicare Assignment
Name
ADETOMIWA OGUNDERE (M.D.)
NPI
1003227745
Phone
(432) 703-5375
Address
701 W 5TH ST
Enumeration Date
15 May 2014
Last Update Date
13 September 2018

Doctor Profile

Medical School Name
TEXAS TECH UNIVERSITY HEALTH SCIENCE CENTER SCHOOL OF MEDICINE
Secondary Phone
2546292601
Graduation Year
2014 (12 years ago)
PAC ID
1254628647
Group Practice PAC ID
0446296818
Professional Enrollment ID
I20181005000952
Address ID
TX764482609EA304XXAVEX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness75
Years active:12State licenses:1Digital endpointsOther names

8,705 FAMILY PRACTICE in TX

Provider Addresses for ADETOMIWA OGUNDERE (M.D.)

  • 701 W 5TH ST

    ODESSA, TX 797634206

    Phone: (432) 703-5375

    Type: Location

  • 3601 4TH ST

    MS 9410

    LUBBOCK, TX 794300002

    Phone: (806) 743-6840

    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: 2018-10-05

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
I20181005000952IFamily PracticeTXTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99238Hospital discharge day management, 30 minutes or less3736$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes2114$0
99204New patient office or other outpatient visit, 45-59 minutes1212$0
View full utilization report →

Insurance plans in this area (ZIP 79763)

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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: 0446296818View full group profile
NameSpecialtyState
Family PracticeTX
-TX
Internal MedicineTX
-TX
-AR
Emergency Medicine, Family PracticeTN
Nurse PractitionerTX
-TX
Obstetrics/Gynecology, Emergency MedicineFL
Nurse PractitionerLA

Reviews

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Frequently asked questions

What is the registry number for ADETOMIWA OGUNDERE (M.D.)?
The registry entry for ADETOMIWA OGUNDERE (M.D.) shows NPI 1003227745.
Does the public listing show ADETOMIWA OGUNDERE (M.D.) as active?
ADETOMIWA OGUNDERE (M.D.)'s NPI record reflects an active status in NPPES.
What does the directory say ADETOMIWA OGUNDERE (M.D.) does?
Insurance directories may phrase it differently, but here ADETOMIWA OGUNDERE (M.D.) maps to Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to ADETOMIWA OGUNDERE (M.D.)?
ADETOMIWA OGUNDERE (M.D.) shows a connection to Odessa, Texas in registry-derived data.
Who maintains ADETOMIWA OGUNDERE (M.D.)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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