ADEBOLANLE AYINDE – Internal Medicine Physician, NPI 1639817653

ADEBOLANLE AYINDE is a healthcare provider. based in Longview, Texas. specializing in INTERNAL MEDICINE. They hold a License No. BP10080604 (TX). The NPI Number for ADEBOLANLE AYINDE is 1639817653

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
ADEBOLANLE AYINDE
NPI
1639817653
Phone
(903) 315-1696
Address
701 E MARSHALL AVE STE 400
Enumeration Date
20 May 2022
Last Update Date
29 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8886458829
Graduation Year
2023 (3 years ago)
PAC ID
8022522556
Group Practice PAC ID
1759621469
Professional Enrollment ID
I20250708001989
Address ID
ME046051534EL50XXXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness85
Years active:4State licenses:2Digital endpointsOther names

13,297 INTERNAL MEDICINE in TX

Provider Addresses for ADEBOLANLE AYINDE

  • 701 E MARSHALL AVE STE 400

    LONGVIEW, TX 756015595

    Phone: (903) 315-1696

    Mailing address matches the actual address.

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: 2025-07-08

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
I20250708001989IInternal MedicineMETBD

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 75601)

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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: 1759621469View full group profile
NameSpecialtyState
Internal MedicineNY
-ME
Family PracticeWY
Internal Medicine, HospitalistNC
Physician AssistantMT
-ME
Physician AssistantKY
Nurse PractitionerME
Internal MedicineNY
Nurse PractitionerNY

Reviews

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Frequently asked questions

What is the registry number for ADEBOLANLE AYINDE?
The registry entry for ADEBOLANLE AYINDE shows NPI 1639817653.
Quick check: is ADEBOLANLE AYINDE active?
Public NPPES data shows ADEBOLANLE AYINDE with an active NPI status right now.
What services align with ADEBOLANLE AYINDE's listing?
ADEBOLANLE AYINDE's public classification highlights Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
What city is tied to ADEBOLANLE AYINDE?
The directory associates ADEBOLANLE AYINDE with Longview, Texas. Check all listed addresses for suites or satellite offices.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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