NPIMap

Individual provider Active NPI

Ebima Clifford Okundaye, M.D

  • Nephrology Physician
  • Pearland, TX
National Provider Identifier
1063546406
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
P1006 Issued in TX
Practice address
11100 Shadow Creek Pkwy
Pearland, TX 77584-7285
Phone
(713) 770-7100
NPI assigned
Mar 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 245205 NY
Nephrology Physician 207RN0300X P1006 TX Primary
Nephrology Physician 207RN0300X 33431 AL

Addresses

Primary practice location

11100 Shadow Creek Pkwy
Pearland, TX 77584-7285

Mailing address

PO Box 1571
Fresno, TX 77545-1571
Phone (281) 942-8001

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
I20191218001493 TX Practitioner - NephrologyPractitioner - Internal Medicine 9436221074 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10970 Shadow Creek Pkwy
Suite 320
Pearland, TX 77584-0121
Phone (973) 885-5457

3315 Burke Rd
Suite 306
Pasadena, TX 77504-1825
Phone (973) 885-5457

Hospital & facility affiliations

  • HCA Houston Healthcare Southeast Hospital, Pasadena, TX, CCN 450097
  • HCA Houston Healthcare Pearland Hospital, Pearland, TX, CCN 670106
  • Memorial Hermann Hospital System Hospital, Houston, TX, CCN 450184
  • HCA Houston Healthcare Clear Lake Hospital, Webster, TX, CCN 450617
  • Houston Methodist Sugarland Hospital Hospital, Sugar Land, TX, CCN 450820

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Texas, PLLC Internal Medicine CurrentSince Mar 21, 2024 Accepting new patients
Ies Hospitalists PLLC CurrentSince Feb 16, 2022 Accepting new patients
Hospitalist Medicine Physicians of New York, PLLC Past Accepting new patients
Clinic Pharmacy Inc Past Accepting new patients
Mount Lassen Emergency Physicians LLC Past Accepting new patients
Hospitalist Medicine Physician of Broome County PLLC Internal Medicine Past Accepting new patients
Texas Em-I Medical Services, PA Internal Medicine Past Accepting new patients

Locations

2801 Franciscan Dr
Bryan, TX 77802
Phone (409) 776-3777

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555

1201 W Frank Ave
Lufkin, TX 75904
Phone (936) 634-8111

600 S Bonham St
Mexia, TX 76667
Phone (254) 562-5332

Organizations & group practices 8

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

Hospital & facility affiliations 10

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": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1063546406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1571",
            "city": "FRESNO",
            "state": "TX",
            "postal_code": "775451571",
            "telephone_number": "281-942-8001",
            "fax_number": "281-724-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 SHADOW CREEK PKWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847285",
            "telephone_number": "713-770-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKUNDAYE",
        "first_name": "EBIMA",
        "middle_name": "CLIFFORD",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "245205",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "P1006",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AL",
            "license": "33431",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

Verify at the official NPI Registry.