Individual provider Active NPI

Arinola Odumusi, M.D.

  • Internal Medicine Physician
  • Prosper, TX
National Provider Identifier
1447602834
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
T4568 Issued in TX
Practice address
291 S Preston Rd Ste 1120
Prosper, TX 75078-1913
Phone
(469) 481-6660
Fax
(469) 481-6561
NPI assigned
Jul 8, 2016
Last updated
Mar 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X T4568 TX Primary

Addresses

Primary practice location

291 S Preston Rd Ste 1120
Prosper, TX 75078-1913

Mailing address

291 S Preston Rd Ste 1120
Prosper, TX 75078-1913
Phone (469) 481-6660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190716003121 NM Practitioner - HospitalistPractitioner - Internal Medicine 0143517458
I20231213000115 TX Practitioner - Internal Medicine 0143517458 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

291 S Preston Rd
Suite 1120
Prosper, TX 75078-1913
Phone (469) 900-2088

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T4568TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group Georgia Inc Internal Medicine CurrentSince Mar 11, 2022 Accepting new patients
Diamondcrest Medical Center Internal Medicine CurrentSince Sep 26, 2023 Accepting new patients

Locations

15059 N Scottsdale Rd
Ste 600
Scottsdale, AZ 85254
Phone (602) 778-3601

705 Dixie St
Carrollton, GA 30117
Phone (770) 812-9666

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

601 Dallas Hwy
Villa Rica, GA 30180
Phone (770) 456-3000

291 S Preston Rd
Ste 1120
Prosper, TX 75078
Phone (469) 481-6660

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1467936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1447602834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 S PRESTON RD STE 1120",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750781913",
            "telephone_number": "469-481-6660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 S PRESTON RD STE 1120",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750781913",
            "telephone_number": "469-481-6660",
            "fax_number": "469-481-6561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODUMUSI",
        "first_name": "ARINOLA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-08",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "T4568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prosper, TX

Sources for this page

Verify at the official NPI Registry.