NPIMap

Individual provider Active NPI

Oluwakunle Olalekan Oluwatosin, MD

  • Interventional Cardiology Physician
  • Osage Beach, MO
National Provider Identifier
1396912796
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
2020036581 Issued in MO
Practice address
54 Hospital Dr
Osage Beach, MO 65065-3050
Phone
(573) 302-4406
Fax
(573) 302-4408
NPI assigned
May 14, 2008
Last updated
Jul 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01065287A IN
Cardiovascular Disease Physician 207RC0000X 51912 WI
Interventional Cardiology Physician 207RI0011X V6205 TX
Interventional Cardiology Physician 207RI0011X 30760 NE
Interventional Cardiology Physician 207RI0011X 2020036581 MO Primary
Hospitalist Physician 208M00000X 01065287A IN

Addresses

Primary practice location

54 Hospital Dr
Osage Beach, MO 65065-3050

Mailing address

1912 Andrea Dr
Jefferson City, MO 65101-6016
Phone (646) 316-0493

Other practice location 1

1521 S Staples St
Corpus Christi, TX 78404-3150
Phone (361) 888-8271

Other practice location 2

3800 S National Ave Ste 400
Springfield, MO 65807-5272
Phone (000) 000-0000

Other names 1

  • Gbenga Lekan, Kunle Oluwatosin Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, MO, TX3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20151210002095 AR Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 1557439262
I20201207000637 MO Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 1557439262 Reassigns benefits to 3 organizations
I20250313002618 TX Practitioner - Interventional Cardiology 1557439262 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Joplin LLCGroup PAC ID 0547300196, 288 clinicians
Laredo Physicians GroupGroup PAC ID 1355582461, 22 clinicians
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

100 Mercy Way
Joplin, MO 64804-4524
Phone (417) 556-6813

10700 McPherson Rd
Laredo, TX 78045-6268
Phone (956) 523-3090

10710 McPherson Rd
Suite 300
Laredo, TX 78045-6411
Phone (956) 523-2783

1150 State Hwy 248
Suite 200
Branson, MO 65616-4186
Phone (417) 336-4112

1521 S Staples St
Suite 500
Corpus Christi, TX 78404-3150
Phone (361) 888-8271

600 Elizabeth St
Corpus Christi, TX 78404-2235
Phone (361) 881-3000

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

PO Box
Suite 846098
Dallas, TX 75284-6098

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.58 of 100Reported as group
Promoting interoperability
100
Improvement activities
40
Cost
65.27

Merit-based Incentive Payment System (MIPS)

Final score
94.19 of 100Reported as group
Promoting interoperability
100
Improvement activities
40
Cost
75.51

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2020036581MOMDInterventional Cardiology Physician
V6205TXMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lester E Cox Medical Centers CurrentSince May 23, 2025 Accepting new patients
Mercy Clinic Joplin LLC Internal Medicine CurrentSince Sep 1, 2025 Accepting new patients
Christus Trinity Clinic Texas Internal Medicine CurrentSince May 24, 2025 Accepting new patients
Skaggs Community Hospital Association CurrentSince May 23, 2025 Accepting new patients
South Arkansas Physician Services LLC Internal Medicine CurrentSince Nov 1, 2015 Accepting new patients
Lake Regional Medical Management, Inc. CurrentSince Dec 1, 2020 Accepting new patients
Laredo Physicians Group Hospitalist CurrentSince Apr 1, 2025 Accepting new patients
Lester E Cox Medical Centers Cardiovascular Disease CurrentSince May 23, 2025 Accepting new patients
Christus Trinity Clinic Texas CurrentSince May 24, 2025 Accepting new patients
Skaggs Community Hospital Association Interventional Cardiology CurrentSince May 23, 2025 Accepting new patients
Mercy Clinic Springfield Communities Internal Medicine Past Accepting new patients
St Marys Physician Services, LLC Interventional Cardiology Past Accepting new patients

Locations

620 W Grove St
Ste 202
El Dorado, AR 71730
Phone (870) 863-2420

700 W Grove St
#2N
El Dorado, AR 71730
Phone (870) 863-2379

1150 State Highway 248
Ste 200
Branson, MO 65616
Phone (417) 336-4112

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

100 Mercy Way
#470
Joplin, MO 64804
Phone (417) 556-6813

54 Hospital Dr
Osage Beach, MO 65065
Phone (573) 280-2772

3800 S National Ave
Ste 400
Springfield, MO 65807
Phone (417) 269-9842

10710 McPherson Rd
Ste 300
Laredo, TX 78045
Phone (956) 489-5454

6801 McPherson Rd
Laredo, TX 78041
Phone (956) 721-0200

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • Direct secure messaging: ooluwatosin579964@christushealth.direct-ci.net

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1210723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1396912796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1912 ANDREA DR",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651016016",
            "telephone_number": "646-316-0493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 HOSPITAL DR",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650653050",
            "telephone_number": "573-302-4406",
            "fax_number": "573-302-4408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1521 S Staples St",
            "address_purpose": "LOCATION",
            "city": "Corpus Christi",
            "state": "TX",
            "postal_code": "784043150",
            "country_code": "US",
            "telephone_number": "361-888-8271",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3800 S National Ave Ste 400",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658075272",
            "country_code": "US",
            "telephone_number": "000-000-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLUWATOSIN",
        "first_name": "OLUWAKUNLE",
        "middle_name": "OLALEKAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-14",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01065287A",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "51912",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "V6205",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NE",
            "license": "30760",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MO",
            "license": "2020036581",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01065287A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GBENGA",
            "last_name": "OLUWATOSIN",
            "middle_name": "LEKAN, KUNLE",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Osage Beach, MO

Sources for this page

Verify at the official NPI Registry.