Active NPI
Oscar Anyabolu
- Surgical Physician Assistant
- Rockwall, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- PA17493
- Practice address
- 3136 Horizon Rd Ste 100
Rockwall, TX 75032-7808 - Phone
- (972) 475-8914
- Fax
- (855) 364-4959
- NPI assigned
- Aug 14, 2023
- Last updated
- May 7, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Surgical Physician Assistant | 363AS0400X | PA17493 | TX | Primary |
Addresses
Primary practice location
3136 Horizon Rd Ste 100
Rockwall, TX 75032-7808
Mailing address
1075 E Betteravia Rd Ste 201
Santa Maria, CA 93454-7023
Phone (805) 621-7651
Other practice location 1
1075 E Betteravia Rd Ste 201
Santa Maria, CA 93454-7023
Phone (805) 621-7651
Other practice location 2
2001 N Jefferson Ave Ste 100
Mount Pleasant, TX 75455-1104
Phone (903) 577-6787
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10864 Texas Health TRL
Fort Worth, TX 76244-4897
Phone (682) 212-2000
3136 Horizon Rd
Suite 100
Rockwall, TX 75032-7808
Phone (972) 475-8914
3150 Horizon Rd
Rockwall, TX 75032-7805
Phone (469) 698-1000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA17493 | TX | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A.T. Still University - College for Healthy Communities | Current | Accepting new patients |
Locations
1075 E Betteravia Rd
#201
Santa Maria, CA 93454
Phone (805) 621-7644
Organizations & group practices 4
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.
-
- Internal Medicine Physician
- Fort Worth, TX
- NPI 1174573596
-
- Orthopaedic Surgery Physician
- Mount Dora, FL
- NPI 1205945763
-
- Student in an Organized Health Care Education/Training Program
- Santa Maria, CA
- NPI 1356222020
Hospital & facility affiliations 12
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Baylor Institute for Rehabilitation
- Rehabilitation Hospital
- Dallas, TX
- NPI 1538465901
Inpatient rehabilitation facility
-
- Orthopaedic Surgery of the Spine Physician
- Plano, TX
- NPI 1184663163
Hospital
-
- Physical Medicine & Rehabilitation Physician
- Richardson, TX
- NPI 1114035383
Hospital
-
dba Christus Mother Frances Hospital Tyler
- General Acute Care Hospital
- Tyler, TX
- NPI 1679578439
-
dba Texas Health Hospital Rockwall
- General Acute Care Hospital
- Rockwall, TX
- NPI 1629138029
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778112000000",
"number": "1063295137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1075 E BETTERAVIA RD STE 201",
"city": "SANTA MARIA",
"state": "CA",
"postal_code": "934547023",
"telephone_number": "805-621-7651",
"fax_number": "805-357-9333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3136 HORIZON RD STE 100",
"city": "ROCKWALL",
"state": "TX",
"postal_code": "750327808",
"telephone_number": "972-475-8914",
"fax_number": "855-364-4959"
}
],
"practiceLocations": [
{
"address_1": "1075 E Betteravia Rd Ste 201",
"address_purpose": "LOCATION",
"city": "Santa Maria",
"state": "CA",
"postal_code": "934547023",
"country_code": "US",
"telephone_number": "805-621-7651",
"fax_number": "805-357-9333",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2001 N Jefferson Ave Ste 100",
"address_purpose": "LOCATION",
"city": "Mount Pleasant",
"state": "TX",
"postal_code": "754551104",
"country_code": "US",
"telephone_number": "903-577-6787",
"fax_number": "903-434-8072",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ANYABOLU",
"first_name": "OSCAR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-08-14",
"last_updated": "2026-05-07",
"certification_date": "2026-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "TX",
"license": "PA17493",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockwall, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.