Individual provider Active NPI

Matthew Olukayode Olagbenro, MD

  • Student in an Organized Health Care Education/Training Program
  • Birmingham, AL
National Provider Identifier
1194427112
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
53271 Issued in AL
Practice address
500 22ND St S Ste 300
Birmingham, AL 35233-3110
Phone
(205) 996-7546
Fax
(205) 731-9761
NPI assigned
Mar 21, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 53271 AL Primary

Addresses

Primary practice location

500 22ND St S Ste 300
Birmingham, AL 35233-3110

Mailing address

510 20TH St S Ste 858
Birmingham, AL 35233-2028
Phone (205) 934-5188

Other practice location 1

1509 6th Ave S Apt 1615
Birmingham, AL 35233-1601
Phone (205) 930-3200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20241015000828 OH Order and Referring Only - General PracticePractitioner - General Practice 9032641162

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53271ALMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC. Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1679356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770076800000",
    "number": "1194427112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 20TH ST S STE 858",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352332028",
            "telephone_number": "205-934-5188",
            "fax_number": "205-731-9761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 22ND ST S STE 300",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352333110",
            "telephone_number": "205-996-7546",
            "fax_number": "205-731-9761"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1509 6th Ave S Apt 1615",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352331601",
            "country_code": "US",
            "telephone_number": "205-930-3200",
            "fax_number": "205-918-1699",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLAGBENRO",
        "first_name": "MATTHEW",
        "middle_name": "OLUKAYODE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-21",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AL",
            "license": "53271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.