ABIDEEN ADEWALE AJUWON (MD) – Family Medicine Physician, NPI 1124373071

ABIDEEN ADEWALE AJUWON (MD) is a healthcare provider. based in Odessa, Texas. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. A170420 (CA). The NPI Number for ABIDEEN ADEWALE AJUWON (MD) is 1124373071

Main info

Male
14 Years Of Experience
Accepts Medicare Assignment
Name
ABIDEEN ADEWALE AJUWON (MD)
NPI
1124373071
Phone
(432) 703-5124
Address
701 W 5TH ST
Enumeration Date
17 July 2012
Last Update Date
18 October 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8057378700
Graduation Year
2012 (14 years ago)
PAC ID
3577832328
Group Practice PAC ID
9739275595
Professional Enrollment ID
I20210416001538
Address ID
CA934363301LO1225XSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience55
Completeness75
Years active:13State licenses:1Digital endpointsOther names

13,190 FAMILY PRACTICE in CA

Provider Addresses for ABIDEEN ADEWALE AJUWON (MD)

  • 701 W 5TH ST

    ODESSA, TX 797634206

    Phone: (432) 703-5124

    Fax: (432) 335-5332

    Type: Mailing

  • 1000 W CARSON ST # 461

    TORRANCE, CA 905022004

    Phone: (310) 222-2700

    Fax: (310) 533-1841

    Type: Location

  • PO BOX 1431

    EL SEGUNDO, CA 902456431

    Phone:

    Type: Mailing

  • 7515 VAN NUYS BLVD

    VAN NUYS, CA 914051949

    Phone: (818) 627-3000

    Type: Location

  • 1000 W Carson St # 461

    Torrance, CA 905022004

    Phone: (310) 222-2700

    Fax: (310) 533-1841

    Type: Location

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: 2021-04-16

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
I20210416001538IFamily PracticeCATBD

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 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: 9739275595View full group profile
NameSpecialtyState
-CA
-CA
General Surgery, General PracticeCA
Family PracticeCA
Diagnostic Radiology, Interventional RadiologyCA
Interventional Radiology, Diagnostic RadiologyIL
Orthopedic SurgeryWA
H E M A T O L O G Y/ O N C O L O G YCA
Family PracticeCA
Marriage And Family TherapistCA

Reviews

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Frequently asked questions

Does ABIDEEN ADEWALE AJUWON (MD) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — ABIDEEN ADEWALE AJUWON (MD) uses 1124373071.
Does the file indicate ABIDEEN ADEWALE AJUWON (MD) is practicing under active NPI?
Directory data currently reports ABIDEEN ADEWALE AJUWON (MD) as active.
What is ABIDEEN ADEWALE AJUWON (MD) best known for clinically?
Directory data describes ABIDEEN ADEWALE AJUWON (MD) with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What address line appears for ABIDEEN ADEWALE AJUWON (MD)?
ABIDEEN ADEWALE AJUWON (MD)'s geographic hint is Odessa, Texas in our summary view.
How many locations tie to this NPI?
5 practice locations appear in the available data.

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