Individual provider Active NPI

Adijat Olubukola Olanrewaju

  • Pediatrics Physician
  • Plano, TX
National Provider Identifier
1083022297
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
T5182 Issued in TX
Practice address
7601 Preston Rd
Plano, TX 75024-3214
Phone
(214) 456-9250
Fax
(214) 456-1240
NPI assigned
Jul 31, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X 305581 LA
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X T5182 TX Primary

Addresses

Primary practice location

7601 Preston Rd
Plano, TX 75024-3214

Mailing address

7601 Preston Rd
Plano, TX 75024-3214
Phone (214) 456-9250

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220729002146 TX Practitioner - Pediatric Medicine 1557666799 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Physician Medical Services for Children Inc Multi-Specialty CurrentSince Jun 10, 2022 Accepting new patients
Dallas Physician Medical Services for Children Inc Multi-Specialty CurrentSince Jun 10, 2022 Accepting new patients
Complex Care Medical Services Corporation Multi-Specialty Past Accepting new patients

Locations

1935 Medical District Dr
#908
Dallas, TX 75235

1935 Medical District Dr
Dallas, TX 75235
Phone (214) 456-2735

7601 Preston Rd
Plano, TX 75024
Phone (469) 303-7300

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1083022297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7601 PRESTON RD",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243214",
            "telephone_number": "214-456-9250",
            "fax_number": "214-456-1240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 PRESTON RD",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243214",
            "telephone_number": "214-456-9250",
            "fax_number": "214-456-1240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLANREWAJU",
        "first_name": "ADIJAT",
        "middle_name": "OLUBUKOLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-31",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "305581",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "T5182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.