Active NPI
Olusimidele Tolulope Ayeni, M.D., PH.D.
- Pediatrics Physician
- Katy, TX
National Provider Identifier
1265876031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- Q8205
- Practice address
- 705 S Fry Rd Ste 120
Katy, TX 77450-2252 - Phone
- (281) 398-3100
- NPI assigned
- Apr 24, 2013
- Last updated
- Jul 26, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | Q8205 | TX | Primary |
Addresses
Primary practice location
705 S Fry Rd Ste 120
Katy, TX 77450-2252
Mailing address
6326 Grand Prominence CT
Katy, TX 77494-7685
Phone (240) 338-7521
Other practice location 1
1 Baylor Plz
BCM 320
Houston, TX 77030-3411
Phone (832) 824-1170
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| Q8205 | TX | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Texas Children's Urgent Care | Pediatrics | Past | Accepting new patients |
| TCH Pediatric Associates, Inc | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- oayeni143898@prddirect.texaschildrens.org
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba TCP Grand Parkway
- Pediatrics Physician
- Sugar Land, TX
- NPI 1861492654
-
- Pediatrics Physician
- Houston, TX
- NPI 1871998963
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658793600000",
"number": "1265876031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6326 GRAND PROMINENCE CT",
"city": "KATY",
"state": "TX",
"postal_code": "774947685",
"telephone_number": "240-338-7521"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "705 S FRY RD STE 120",
"city": "KATY",
"state": "TX",
"postal_code": "774502252",
"telephone_number": "281-398-3100"
}
],
"practiceLocations": [
{
"address_1": "1 Baylor Plz",
"address_2": "BCM 320",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770303411",
"country_code": "US",
"telephone_number": "832-824-1170",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "AYENI",
"first_name": "OLUSIMIDELE",
"middle_name": "TOLULOPE",
"name_prefix": "Dr.",
"credential": "M.D., PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-24",
"last_updated": "2022-07-26",
"certification_date": "2022-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "Q8205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Katy, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.