Oluwaseun Akeredolu, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA07303 Issued in TX

Practice address

22219 Bridgestone Oak Dr
Spring, TX 77388-3534

Phone

(281) 971-1145

NPI assigned

Jul 25, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Oluwaseun Egbejimi Former name

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

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premise Health of Texas Medical PAGroup PAC ID 1052383213, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Premise Health of Texas Medical PA

  dba Westlake Health and Wellness Center

  • Multi-Specialty Clinic/Center
  • Houston, TX
  • NPI 1558640854
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1343174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343174400000",
    "number": "1255687497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22219 BRIDGESTONE OAK DR",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773883534",
            "telephone_number": "281-971-1145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22219 BRIDGESTONE OAK DR",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773883534",
            "telephone_number": "281-971-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKEREDOLU",
        "first_name": "OLUWASEUN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-25",
        "last_updated": "2012-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA07303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLUWASEUN",
            "last_name": "EGBEJIMI",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nagi Hassan Ahmed, MBBS
• Samira Yasmeen Ahmed, MD
• Yeseul Ahn
• Aisha Nasir MD PA
• Ak & Prestige LLC (Prestige Homecare)
• Marina J Akerman, DDS PA
• Colt Ace Akin
• Folasade Mercy Akinfemiwa
• Todd Drake Akins, M.D.
• Ugonna Akoh, PT, DPT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2012; 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.