Individual provider Active NPI

Matthew B Olaitan

  • Registered Nurse
  • San Antonio, TX
National Provider Identifier
1386509321
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
1071964 Issued in TX
Practice address
12463 Chazelle
San Antonio, TX 78254-4856
Phone
(401) 450-8218
Fax
(401) 450-8218
NPI assigned
Dec 22, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Registered Nurse 163WC0400X 1071964 TX
Registered Nurse 163W00000X 1071964 TX Primary

Addresses

Primary practice location

12463 Chazelle
San Antonio, TX 78254-4856

Mailing address

12463 Chazelle
San Antonio, TX 78254-4856
Phone (401) 450-8218

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1071964TXMDCase Management Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
El-Shannon Non Emergency Medical Transportation Current Accepting new patients
El-Shannon Non Emergency Medical Transportation Current Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1766361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1386509321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12463 CHAZELLE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782544856",
            "telephone_number": "401-450-8218",
            "fax_number": "401-450-8218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12463 CHAZELLE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782544856",
            "telephone_number": "401-450-8218",
            "fax_number": "401-450-8218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLAITAN",
        "first_name": "MATTHEW",
        "middle_name": "B",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-12-22",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "TX",
            "license": "1071964",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "1071964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2025; 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.