NPIMap

Individual provider Active NPI

Mobolaji O. Olulade, M.D.

  • Internal Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1093976557
Registry record updated Jul 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
29128 Issued in OK
Practice address
4401 S Western Ave
Oklahoma City, OK 73109-3413
Phone
(405) 713-7403
Fax
(405) 713-2974
NPI assigned
Jun 18, 2008
Last updated
Jul 20, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2017

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 29128 OK Primary

Addresses

Primary practice location

4401 S Western Ave
Oklahoma City, OK 73109-3413

Mailing address

5300 N Independence Ave
280
Oklahoma City, OK 73112-5556
Phone (405) 713-7403

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20120905000147 OK Practitioner - HospitalistPractitioner - Internal Medicine 9739350158 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Howard University College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectrum Healthcare Solutions, PLLCGroup PAC ID 7618255118, 18 clinicians
Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians

Practice addresses (Care Compare)

4220 N Classen Blvd
Suite a
Oklahoma City, OK 73118-2416
Phone (405) 768-5749

4401 S Western Ave
Oklahoma City, OK 73109-3413
Phone (405) 636-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. 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
Spectrum Healthcare Solutions, PLLC CurrentSince Jan 1, 2019 Accepting new patients
Integris Ambulatory Care Corporation Internal Medicine CurrentSince Jul 25, 2012 Accepting new patients
Integris South Oklahoma City Hospital Corporation PastSince Jul 1, 2017 Accepting new patients
Curahealth Oklahoma, LLC Past Accepting new patients
Integris Baptist Medical Center Inc Past Accepting new patients

Locations

3300 NW Expressway St
Oklahoma City, OK 73112
Phone (405) 251-2815

5300 N Independence Ave
Ste 280
Oklahoma City, OK 73112
Phone (405) 552-0155

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

315 SW 80th St
Oklahoma City, OK 73139
Phone (214) 272-2774

4401 S Western Ave
Oklahoma City, OK 73109
Phone (405) 636-7000

4220 N Classen Blvd
Ste A
Oklahoma City, OK 73118
Phone (405) 768-5749

Organizations & group practices 5

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 12

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": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500508800000",
    "number": "1093976557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE",
            "address_2": "280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125556",
            "telephone_number": "405-713-7403",
            "fax_number": "405-713-2974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 S WESTERN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093413",
            "telephone_number": "405-713-7403",
            "fax_number": "405-713-2974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLULADE",
        "first_name": "MOBOLAJI",
        "middle_name": "O.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-18",
        "last_updated": "2017-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "29128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.