Benedict O Olusola, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

J7118 Issued in TX

Practice address

1700 N Hampton Rd
Suite 100
Desoto, TX 75115-2392

Phone

(972) 228-3677

Fax

(972) 228-3672

NPI assigned

Jul 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Ahmed Khan MD PA

  • Surgery Physician
  • Dallas, TX
  • NPI 1073773115
  NPD (past)
• Aralile PLLC

  • Clinic/Center
  • Dallas, TX
  • NPI 1093802142
  NPD (past)
• Arlington Emergency Medicine Assoc

  • Emergency Medicine Physician
  • Arlington, TX
  • NPI 1891764361
  NPD (past)
• Motley Emergency Physicians

  • Emergency Medicine Physician
  • Mesquite, TX
  • NPI 1972558401
  NPD (past)
• Texas Em-1 Medical Services, PA

  • Physician Assistant
  • Mesquite, TX
  • NPI 1295780757
  NPD (past)
• Texas Em-I Medical Services, PA

  • Emergency Medicine Physician
  • Paris, TX
  • NPI 1376715268
  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1376566125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 628",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751230628",
            "telephone_number": "972-228-3677",
            "fax_number": "972-228-3672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 N HAMPTON RD",
            "address_2": "SUITE 100",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152392",
            "telephone_number": "972-228-3677",
            "fax_number": "972-228-3672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLUSOLA",
        "first_name": "BENEDICT",
        "middle_name": "O",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "J7118",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J7118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139957825",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0032QR",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Funmilayo Oladun
• Emelda Olisaeke
• Olukemi Motunrayo Ologun, RN
• Modupe Olubukola Olojo
• Chioma Olonade, P.T
• Elo Edith Omakor, NURSE PRACTITIONER
• Omega Care Homes, Inc
• Omni Spine Pain Management, PLLC
• Linda Nkechi Oniah, D.D.S.
• Only Way to Live Cleaning Service (Smith Family Services)

• Family Medicine Physician in Desoto, TX
• Providers in Desoto, 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, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.