Individual provider Active NPI

Lawson Olumide Ishalaiye

  • Internal Medicine Physician
  • Brandon, FL
National Provider Identifier
1164008728
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
U9275 Issued in TX
Practice address
119 Oakfield Dr
Brandon, FL 33511-5779
Phone
(813) 681-5551
NPI assigned
Mar 23, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X U9275 TX Primary

Addresses

Primary practice location

119 Oakfield Dr
Brandon, FL 33511-5779

Mailing address

119 Oakfield Dr
Brandon, FL 33511-5779

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
I20240701002113 TX Practitioner - Internal Medicine 9335549401 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Medicine Physicians of Texas PLLCGroup PAC ID 3476688318, 685 clinicians

Practice addresses (Care Compare)

1501 S Coulter St
Northwest Texas Heatlhcare System
Amarillo, TX 79106-1770
Phone (806) 354-1000

18951 N Memorial Dr
Humble, TX 77338-4217
Phone (281) 319-8409

2600 Saint Michael Dr
Texarkana, TX 75503-5220
Phone (903) 614-5110

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.55 of 100Reported as group
Quality
70.56
Improvement activities
40
Cost
72.48

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
U9275TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usacs Integrated Acute Care Services of Texas, PLLC Internal Medicine CurrentSince Nov 1, 2024 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Internal Medicine CurrentSince Jul 1, 2024 Accepting new patients
HCC of Laredo LLC Internal Medicine CurrentSince Jul 1, 2024 Accepting new patients
Northwest Texas Healthcare System Inc Past Accepting new patients

Locations

3501 Mills Ave
Austin, TX 78731
Phone (512) 324-1017

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

260 Cully Dr
Kerrville, TX 78028
Phone (830) 258-7323

1700 E Saunders St
Laredo, TX 78041
Phone (956) 206-6971

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

Organizations & group practices 4

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 7

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": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1164008728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 OAKFIELD DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 OAKFIELD DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115779",
            "telephone_number": "813-681-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISHALAIYE",
        "first_name": "LAWSON",
        "middle_name": "OLUMIDE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-23",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "U9275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.