Olusola Tijani, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

329612 Issued in LA

Practice address

6110 Main St Ste B
Zachary, LA 70791-4079

Phone

(225) 570-4070

NPI assigned

Apr 13, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Olusola Abigail Komolafe Former name

Medicare fee-for-service enrollment

Enrolled in LA

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

Specialty

Pediatric Medicine

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hospital Service District 1 of East Baton Rouge ParishGroup PAC ID 0941191902, 44 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Hospital Service District 1 of East Baton Rouge Parish

  • General Acute Care Hospital
  • Zachary, LA
  • NPI 1962437681
  Medicare reassignment Care Compare group NPD
• Hospital Service District 1 of East Baton Rouge Parish

  • Otolaryngology Physician
  • Zachary, LA
  • NPI 1609302918
  NPD
• Hospital Service District 1 of East Baton Rouge Parish

  • Psychiatry Physician
  • Zachary, LA
  • NPI 1679466577
  NPD
• Hospital Service District 1 of East Baton Rouge Parish

  • General Acute Care Hospital
  • Zachary, LA
  • NPI 1376591941
  NPD (past)
• Hospital Service District 1 of East Baton Rouge Parish

  • Pediatrics Physician
  • Zachary, LA
  • NPI 1508380197
  NPD (past)

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

{
    "created_epoch": "1523577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1265929418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 MAIN ST",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707914037",
            "telephone_number": "225-658-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6110 MAIN ST STE B",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707914079",
            "telephone_number": "225-570-4070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 S Coulter St Ste 1500",
            "address_purpose": "LOCATION",
            "city": "Amarillo",
            "state": "TX",
            "postal_code": "791061786",
            "country_code": "US",
            "telephone_number": "806-414-9800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIJANI",
        "first_name": "OLUSOLA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-13",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "329612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLUSOLA",
            "last_name": "KOMOLAFE",
            "middle_name": "ABIGAIL",
            "prefix": "MRS.",
            "credential": "OLUSOLA KOMOLAFE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Thomas N. Trahan, M.D. LLC
• Ashley Talbot Thompson
• Charles Allen Thompson, M.D.
• Delayshia Thompson
• Gloria Thompson, LCSW
• TKZ Pediatrics LLC
• Amy Baum Tomb, ANP
• Toomey Belanger Eye Care
• Tots Talk 2 LLC
• Michelle Trahan, SLP

• Pediatrics Physician in Zachary, LA
• Providers in Zachary, LA by specialty
• Pediatrics Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.