Individual provider Active NPI

Frank Edoze Okosun Jr., M.D

  • Internal Medicine Physician
  • Lake Jackson, TX
National Provider Identifier
1093027807
Registry record updated Dec 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
P7174 Issued in TX
Practice address
188 Abner Jackson Pkwy
Lake Jackson, TX 77566-5160
Phone
(979) 266-9776
Fax
(979) 529-2952
NPI assigned
Jul 9, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X P7174 TX Primary

Addresses

Primary practice location

188 Abner Jackson Pkwy
Lake Jackson, TX 77566-5160

Mailing address

188 Abner Jackson Pkwy
Lake Jackson, TX 77566-5160
Phone (979) 266-9776

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
I20131004000074 TX Practitioner - Emergency MedicinePractitioner - Internal Medicine 0648404798 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

188 Abner Jackson Pkwy
Lake Jackson, TX 77566-5160
Phone (979) 266-9776

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brazos Primary Care Associates CurrentSince Oct 5, 2015 Accepting new patients

Locations

201 Oak Dr S
Ste 102
Lake Jackson, TX 77566
Phone (979) 266-9776

188 Abner Jackson Pkwy
Lake Jackson, TX 77566
Phone (979) 266-9776

Interoperability endpoints

  • Direct secure messaging: fokosun457833@direct.stlukeshealth.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/ECIIDD/Endpoint/ECIIDD
  • FHIR API: https://fhir4.healow.com/fhir/r4/ECIIDD

Organizations & group practices 1

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 1

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": "1278633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607212800000",
    "number": "1093027807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 ABNER JACKSON PKWY",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665160",
            "telephone_number": "979-266-9776",
            "fax_number": "979-529-2952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 ABNER JACKSON PKWY",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665160",
            "telephone_number": "979-266-9776",
            "fax_number": "979-529-2952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKOSUN",
        "first_name": "FRANK",
        "middle_name": "EDOZE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-09",
        "last_updated": "2020-12-06",
        "certification_date": "2020-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "P7174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Jackson, TX

Sources for this page

Verify at the official NPI Registry.