Individual provider Active NPI

Olakunle Iluyomade, MD

  • Pulmonary Disease Physician
  • Lewisville, TX
National Provider Identifier
1366546525
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
M7288 Issued in TX
Practice address
475 Elm St Ste 100
Lewisville, TX 75057-3764
Phone
(214) 222-3571
Fax
(214) 744-5131
NPI assigned
Sep 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X M7288 TX Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X M7288 TX
Internal Medicine Physician 207R00000X M7288 TX

Addresses

Primary practice location

475 Elm St Ste 100
Lewisville, TX 75057-3764

Mailing address

475 Elm St Ste 100
Lewisville, TX 75057-3764
Phone (214) 222-3571

Other identifiers 2

IdentifierTypeStateIssuer
P00788798OtherTXRR MEDICARE
1882896-03MedicaidTX

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070829000213 TX Practitioner - Internal MedicinePractitioner - Critical Care (Intensivists)Practitioner - Pulmonary Disease 4284548272 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Critical Care (Intensivists), Pulmonary Disease
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3311 Yucca Dr
Suite 200
Flower Mound, TX 75028-2743
Phone (214) 774-5130

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Apex Pulmonary Consultants PA Pulmonary Disease CurrentSince Feb 26, 2024 Accepting new patients
Alpha Pulmonary Critical Care Consultants, PLLC Pulmonary Disease PastSince May 15, 2008 Accepting new patients
Alpha Pulmonary Critical Care Consultants, PLLC Pulmonary Disease Past Accepting new patients
Congenital Heart Surgery Center PLLC Past Accepting new patients

Locations

508 Bedford Rd
Bedford, TX 76022
Phone (214) 774-5130

475 Elm St
Ste 100
Lewisville, TX 75057
Phone (214) 222-8150

118 Lynn Ave
Ste 100
Lewisville, TX 75057
Phone (214) 396-8877

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CJABED/Endpoint/CJABED
  • FHIR API: https://fhir4.healow.com/fhir/r4/FACFDD/Endpoint/FACFDD

Organizations & group practices 4

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 & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1366546525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 ELM ST STE 100",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750573764",
            "telephone_number": "214-222-3571",
            "fax_number": "214-744-5131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 ELM ST STE 100",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750573764",
            "telephone_number": "214-222-3571",
            "fax_number": "214-744-5131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILUYOMADE",
        "first_name": "OLAKUNLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TX",
            "license": "M7288",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "TX",
            "license": "M7288",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M7288",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00788798",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1882896-03",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisville, TX

Sources for this page

Verify at the official NPI Registry.