Michael G Omotola, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA12295 Issued in TX

Practice address

4135 Belt Line Rd Ste 124
Addison, TX 75001-5879

Phone

(469) 495-9126

Fax

(469) 495-0726

NPI assigned

Jul 26, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Eastern Virginia Medical School, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Primamed Physicians, PLLCGroup PAC ID 9234027897, 62 clinicians

Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Questcare Medical Services PLLCGroup PAC ID 6204739402, 43 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michael.omotolapac.p11@direct.nextcare.nextgenshare.com

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.

• Healthtexas Provider Network

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1760488936
  Medicare reassignment Care Compare group NPD
• Primamed Physicians PLLC

  • Urgent Care Clinic/Center
  • Dallas, TX
  • NPI 1164494068
  Medicare reassignment Care Compare group NPD
• Questcare Medical Services, PLLC

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1912059247
  Medicare reassignment Care Compare group
• Healthtexas Provider Network

  • Anesthesiology Physician
  • Lakeway, TX
  • NPI 1104714583
  NPD
• Citimed, P.a.

  • Family Medicine Physician
  • Arlington, TX
  • NPI 1487823316
  NPD (past)
• Healthtexas Provider Network

  • Family Medicine Physician
  • Plano, TX
  • NPI 1003811639
  NPD (past)

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

{
    "created_epoch": "1532563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1124505615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 W 20TH ST UNIT 11386",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235171287",
            "telephone_number": "512-363-3257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4135 BELT LINE RD STE 124",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750015879",
            "telephone_number": "469-495-9126",
            "fax_number": "469-495-0726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2520 W I 20",
            "address_purpose": "LOCATION",
            "city": "Grand Prairie",
            "state": "TX",
            "postal_code": "750527280",
            "country_code": "US",
            "telephone_number": "512-363-3257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OMOTOLA",
        "first_name": "MICHAEL",
        "middle_name": "G",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-26",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA12295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Addison, TX
• Providers in Addison, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.