Adebola Temitope Ifafore, MD - Medicare Emergency Medicine in Tyler, TX

Adebola Temitope Ifafore, MD is a medicare enrolled "Emergency Medicine" physician in Tyler, Texas. Her current practice location is 800 E Dawson St, Tyler, Texas. You can reach out to her office (for appointments etc.) via phone at (903) 531-5000.

Adebola Temitope Ifafore is licensed to practice in Texas (license number P4966) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1124296132.

Contact Information

Adebola Temitope Ifafore, MD
800 E Dawson St,
Tyler, TX 75701-2036
(903) 531-5000
Not Available



Physician's Profile

Full NameAdebola Temitope Ifafore
GenderFemale
SpecialityEmergency Medicine
Location800 E Dawson St, Tyler, Texas
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1124296132
  • Provider Enumeration Date: 02/12/2008
  • Last Update Date: 08/07/2015
  Medicare PECOS Information:
  • PECOS PAC ID: 5395818447
  • Enrollment ID: I20130820000081

Medical Identifiers

Medical identifiers for Adebola Temitope Ifafore such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1124296132NPI-NPPES
323250604MedicaidTX
P01246225OtherTXRAIL ROAD
323250602MedicaidTX
8DQ931OtherTXBCBS
8DQ932OtherTXBCBS
P01246215OtherTXRAIL ROAD
P01246267OtherTXRAIL ROAD
P01478949OtherTXRAIL ROAD
8DP930OtherTXBCBS
323250603MedicaidTX
323250601MedicaidTX
8FB278OtherTXBCBS

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207P00000XEmergency Medicine P4966 (Texas)Primary
207P00000XEmergency Medicine 046170 (Connecticut)Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Adebola Temitope Ifafore allows following entities to bill medicare on her behalf.
Entity NameChristus Trinity Clinic
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1285684225
PECOS PAC ID: 3072426741
Enrollment ID: O20031204001091

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Entity NameMother Frances Hospital Jacksonville
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1952306672
PECOS PAC ID: 5597751024
Enrollment ID: O20040421001092

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Entity NameMother Frances Hospital Regional Health Care Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1679578439
PECOS PAC ID: 9234025636
Enrollment ID: O20040610001042

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Entity NameNortheast Texas Emergency Physicians Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1114607611
PECOS PAC ID: 8527420306
Enrollment ID: O20230810001225

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Adebola Temitope Ifafore is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Adebola Temitope Ifafore, MD
Po Box 841656,
Dallas, TX 75284-7522

Ph: (903) 531-5000
Adebola Temitope Ifafore, MD
800 E Dawson St,
Tyler, TX 75701-2036

Ph: (903) 531-5000

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Emergency Medicine Doctors in Tyler, TX

James Carr, M.D.
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 800 E Dawson St, Tyler, TX 75701
Phone: 903-606-4262    
Dr. Shawn D Pierce, MD
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 833 S Beckham Ave, Tyler, TX 75701
Phone: 903-780-4396    
Dr. James Michael Wilson, MD, MPH
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 800 E Dawson St, Tyler, TX 75701
Phone: 903-525-1914    
Dr. Dallas Wright, D.O.
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 800 E Dawson St, Tyler, TX 75701
Phone: 903-531-4262    Fax: 903-531-5097
Everett Dean Holley, MD
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 800 E Dawson St, Tyler, TX 75701
Phone: 903-531-4262    
Dr. Jackie Rose, MD
Emergency Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 1000 S Beckham Ave, Tyler, TX 75701
Phone: 903-597-0351    Fax: 903-592-5282
Steven W Cooley, M.D.
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 270 Saddle Creek Dr, Tyler, TX 75703
Phone: 903-574-4341    

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