Oladapo O Odumosu, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

30700 Issued in AZ

Practice address

28248 N Tatum Blvd
BLDG B-1 #605
Cave Creek, AZ 85331-6343

Phone

(602) 996-5595

Fax

(602) 996-5610

NPI assigned

Feb 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Dvma, LLC

  • Internal Medicine Physician
  • Peoria, AZ
  • NPI 1194893800
  Medicare reassignment
• Ipn of Arizona, PLC

  • Internal Medicine Physician
  • Glendale, AZ
  • NPI 1538119284
  NPD (past)
• Seasons Hospice & Palliative Care of Arizona, LLC

  • Community Based Hospice Care Agency
  • Phoenix, AZ
  • NPI 1053609727
  NPD (past)

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

{
    "created_epoch": "1140048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372377600000",
    "number": "1104890854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28248 N TATUM BLVD",
            "address_2": "BLDG B-1 #605",
            "city": "CAVE CREEK",
            "state": "AZ",
            "postal_code": "853316343",
            "telephone_number": "602-996-5595",
            "fax_number": "602-996-5610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28248 N TATUM BLVD",
            "address_2": "BLDG B-1 #605",
            "city": "CAVE CREEK",
            "state": "AZ",
            "postal_code": "853316343",
            "telephone_number": "602-996-5595",
            "fax_number": "602-996-5610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODUMOSU",
        "first_name": "OLADAPO",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-16",
        "last_updated": "2013-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "30700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "30700",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "724543",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyra Nidds, ATC
• David Nisanov
• North Valley Compounding Pharmacy
• Andrea O'Donnell, NTP
• Mohammad Odeh, RPH
• Heidi Olmos, PHARMD
• Brittany Olson
• Omega Medical Supply Inc.
• Omniwest, LLC
• One to One Primary Care, PLLC

• Internal Medicine Physician in Cave Creek, AZ
• Providers in Cave Creek, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.