Oluwaseun Odumosu, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R5786 Issued in TX

Practice address

420 Johnson Rd Ste 304
Keller, TX 76248-3463

Phone

(817) 710-3040

Fax

(989) 200-4650

NPI assigned

Jul 23, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 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

Specialty

Family PracticeAlso: Geriatric Medicine

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vine Family Medicine PLLCGroup PAC ID 9537563416, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BIBFCD/Endpoint/BIBFCD
• Direct secure messaging: oluwaseun.odumosu@txvifm.eclinicaldirectplus.com

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.

• Vine Family Medicine PLLC

  • Family Medicine Physician
  • Keller, TX
  • NPI 1407427420
  Medicare reassignment Care Compare group NPD
• Texas Health Physicians Group

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

  Family Medicine

  Medicare reassignment NPD (past)
• Texas Health Physicians Group

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1053767897

  Family Medicine

  NPD
• Texas Health Physicians Group

  • Sleep Disorder Diagnostic Clinic/Center
  • Fort Worth, TX
  • NPI 1114395969
  NPD
• Texas Health Physicians Group

  • Sleep Disorder Diagnostic Clinic/Center
  • Dallas, TX
  • NPI 1174992051
  NPD
• Neuropathy & Pain Centers of Texas PLLC

  • Adult Medicine Physician
  • Keller, TX
  • NPI 1902274186
  NPD (past)

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

{
    "created_epoch": "1279843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664668800000",
    "number": "1356654909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 JOHNSON RD STE 304",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762483463",
            "telephone_number": "817-710-3040",
            "fax_number": "989-200-4650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 JOHNSON RD STE 304",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762483463",
            "telephone_number": "817-710-3040",
            "fax_number": "989-200-4650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODUMOSU",
        "first_name": "OLUWASEUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-23",
        "last_updated": "2022-10-02",
        "certification_date": "2022-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R5786",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MT197589",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "oluwaseun.odumosu@vinefamilymedicine.org",
            "affiliation": "N",
            "address_1": "420 Johnson Rd Ste 304",
            "city": "Keller",
            "state": "TX",
            "country_code": "US",
            "postal_code": "762483463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nuhealth Pharmacy
• Oasis Dental, P.a.
• Sierra Ochekwu, LCSW
• Alissa Ochoa
• Ochuele Odumosu, M.D.
• Michalla Oldham
• Marshall A Olson, DDS
• Omar a. Gomez, M.D.,P.a.
• Optum Health & Sport Therapy
• Optum Health and Sport Therapy

• Family Medicine Physician in Keller, TX
• Providers in Keller, 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 Oct 2, 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.
• 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.