Individual provider Active NPI

Olakunle Ayodele Adebayo Folorunso

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1336634484
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
721 W Britton Rd
Oklahoma City, OK 73114-2909
Phone
(405) 632-6688
Fax
(844) 689-9671
NPI assigned
Jun 29, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2938 OK
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

721 W Britton Rd
Oklahoma City, OK 73114-2909

Mailing address

3000 N Grand Blvd
Oklahoma City, OK 73107-1818
Phone (405) 632-6688

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250417000757 TX Practitioner - Physician Assistant 8325396575 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2938OKMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
U S Health Dept of Health & Human Services CurrentSince Jan 4, 2025 Accepting new patients
US Dept of HHS Family Medicine CurrentSince Jan 4, 2025 Accepting new patients

Locations

669 Agency Main St
Harlem, MT 59526
Phone (406) 353-3100

Organizations & group practices 3

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": "1530230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1336634484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 N GRAND BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731071818",
            "telephone_number": "405-632-6688",
            "fax_number": "844-689-9671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 W BRITTON RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731142909",
            "telephone_number": "405-632-6688",
            "fax_number": "844-689-9671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOLORUNSO",
        "first_name": "OLAKUNLE",
        "middle_name": "AYODELE ADEBAYO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-29",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "2938",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.