Olubukola Tokunbo Amudipe, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

Q8005 Issued in TX

Practice address

5701 Bryant Irvin Rd Ste 201
Fort Worth, TX 76132-4026

Phone

(817) 263-2500

Fax

(817) 346-4006

NPI assigned

Mar 21, 2007

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 identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

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.

• Fort Worth Internal Medicine PA

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1851432462
  Medicare reassignment NPD
• Texas Health Physicians Group

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1174573596

  Family Medicine

  NPD (past)
• Potomac Physicians PA

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1790706844
  NPD (past)

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1346366333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 BRYANT IRVIN RD STE 201",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324026",
            "telephone_number": "817-263-2500",
            "fax_number": "817-346-4006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 BRYANT IRVIN RD STE 201",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324026",
            "telephone_number": "817-263-2500",
            "fax_number": "817-346-4006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMUDIPE",
        "first_name": "OLUBUKOLA",
        "middle_name": "TOKUNBO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D65267",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q8005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "363252301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bonane Amosi
• Michael Charles Ampelas, DO
• Amplecare LLC
• Lilianna Chapa Amponsah, MS
• Amts, LLC
• William Amwayi
• Amy N Bender DDS, PA
• An Open Door Group Home, Inc
• Joseph An, PA-C
• Ife-Atu Courtney Anachebe, PHARM.D.

• Family Medicine Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.