NPIMap

Individual provider Active NPI

Bekele Chamiso Olbamo, MD

  • Family Medicine Physician
  • Irving, TX
National Provider Identifier
1053554360
Registry record updated May 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
N3958 Issued in TX
Practice address
4545 Fuller Dr
Suite 325
Irving, TX 75038-6521
Phone
(972) 870-5511
Fax
(972) 870-5512
NPI assigned
Apr 16, 2009
Last updated
May 21, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X N3958 TX Primary
Geriatric Medicine (Family Medicine) Physician 207QG0300X N3958 TX

Addresses

Primary practice location

4545 Fuller Dr
Suite 325
Irving, TX 75038-6521

Mailing address

PO Box 1239
Troy, MI 48099-1239
Phone (248) 824-6600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110110000660 TX Practitioner - Family Practice 3072702877 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vpa of Texas PLLCGroup PAC ID 7618911660, 67 clinicians

Practice addresses (Care Compare)

Irving, TX 75038
Phone (972) 870-5511

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
N3958TXMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa of Texas PLLC Family Medicine CurrentSince Sep 13, 2010 Accepting new patients
Iah of Texas, PLLC Family Medicine CurrentSince Jan 1, 2015 Accepting new patients
Vpa of Texas PLLC CurrentSince Sep 13, 2010 Accepting new patients
Vpa of Texas PLLC Family Medicine Current Accepting new patients
Family Health Partners, P.a. Family Medicine PastSince May 22, 2016 Accepting new patients

Locations

500 Kirts Blvd
Ste 100
Troy, MI 48084
Phone (214) 824-6000

7800 Shoal Creek Blvd
Ste 118W
Austin, TX 78757
Phone (512) 374-0700

1301 W 7th St
Ste 121
Ft Worth, TX 76102
Phone (817) 348-0425

8588 Katy Fwy
Ste 226A
Houston, TX 77024
Phone (713) 532-6884

4545 Fuller Dr
Ste 325
Irving, TX 75038
Phone (972) 870-5511

5414 Fredericksburg Rd
Ste 100A
San Antonio, TX 78229
Phone (210) 468-0800

Interoperability endpoints

  • Direct secure messaging: bekele.olbamo.1@32913.direct.athenahealth.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1239840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369094400000",
    "number": "1053554360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1239",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480991239",
            "telephone_number": "248-824-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 FULLER DR",
            "address_2": "SUITE 325",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750386521",
            "telephone_number": "972-870-5511",
            "fax_number": "972-870-5512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLBAMO",
        "first_name": "BEKELE",
        "middle_name": "CHAMISO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-16",
        "last_updated": "2013-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N3958",
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "TX",
            "license": "N3958",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.