Individual provider Active NPI

Olubukola Sami

  • Family Nurse Practitioner
  • Round Rock, TX
National Provider Identifier
1194557124
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1168642 Issued in TX
Practice address
PO Box 5042
Round Rock, TX 78683-5042
Phone
(512) 663-2487
NPI assigned
Aug 19, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1168642 TX Primary

Addresses

Primary practice location

PO Box 5042
Round Rock, TX 78683-5042

Mailing address

PO Box 5042
Round Rock, TX 78683-5042
Phone (512) 663-2487

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241030001956 TX Practitioner - Nurse Practitioner 6204369143 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ministering Physicians, P.a.Group PAC ID 2365450202, 6 clinicians

Practice addresses (Care Compare)

3000 Joe Dimaggio Blvd
Suite 15
Round Rock, TX 78665-3991
Phone (817) 538-9971

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1168642TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ministering Physicians, P.a. CurrentSince Sep 30, 2024 Accepting new patients

Locations

3000 Joe Dimaggio Blvd
Ste 15
Round Rock, TX 78665
Phone (512) 246-6170

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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": "1724025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1194557124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5042",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786835042",
            "telephone_number": "512-663-2487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 5042",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786835042",
            "telephone_number": "512-663-2487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMI",
        "first_name": "OLUBUKOLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-19",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1168642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

Verify at the official NPI Registry.