Individual provider Active NPI

Adetunji Hakeem Oshun, PA-C

  • Physician Assistant
  • Irving, TX
National Provider Identifier
1336487925
Registry record updated May 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA08317 Issued in TX
Practice address
916 W 6TH St
Irving, TX 75060-3874
Phone
(972) 975-5455
Fax
(469) 666-9422
NPI assigned
Jan 16, 2013
Last updated
May 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TX
Physician Assistant 363A00000X PA08317 TX Primary

Addresses

Primary practice location

916 W 6TH St
Irving, TX 75060-3874

Mailing address

916 W 6TH St
Irving, TX 75060-3874
Phone (972) 975-5444

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
I20130530000027 TX Practitioner - Physician Assistant 5496993602 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Sep 15, 2014 Accepting new patients
Callon Doc Physician Assistant Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Sep 15, 2014 Accepting new patients
Inwood Medical Clinic Inc. PastSince Mar 1, 2019 Accepting new patients

Locations

1401 21st St
Ste R
Sacramento, CA 95811
Phone (316) 516-2853

7901 4th St N
Ste 300
St Petersburg, FL 33702
Phone (615) 478-6748

8355 Walnut Hill Ln
Ste 200B
Dallas, TX 75231
Phone (480) 400-4889

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

1950 Record Crossing Rd
Dallas, TX 75235
Phone (214) 638-1500

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1358294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1336487925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 W 6TH ST",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750603874",
            "telephone_number": "972-975-5444",
            "fax_number": "469-666-9422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 W 6TH ST",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750603874",
            "telephone_number": "972-975-5455",
            "fax_number": "469-666-9422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSHUN",
        "first_name": "ADETUNJI",
        "middle_name": "HAKEEM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-16",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA08317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.