Individual provider Active NPI

Omobolanle Mutiat Oji, NP

  • Primary Care Nurse Practitioner
  • Houston, TX
National Provider Identifier
1467992719
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
AP132168 Issued in TX
Practice address
1919 Old Spanish TRL
Houston, TX 77054-2003
Phone
(713) 798-4321
NPI assigned
Mar 6, 2017
Last updated
Sep 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP132168 TX
Adult Health Nurse Practitioner 363LA2200X AP132168 TX
Primary Care Nurse Practitioner 363LP2300X AP132168 TX Primary

Addresses

Primary practice location

1919 Old Spanish TRL
Houston, TX 77054-2003

Mailing address

2828 Hayes Rd Apt 734
Houston, TX 77082-6637
Phone (917) 202-6310

Other practice location 1

2828 Hayes Rd Apt 734
Houston, TX 77082-6637
Phone (917) 202-6310

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171108000889 TX Practitioner - Nurse Practitioner 3971869991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baylor College of MedicineGroup PAC ID 8022243971, 1,230 clinicians

Practice addresses (Care Compare)

1919 Old Spanish TRL
Houston, TX 77054-2003
Phone (832) 957-6500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Sep 1, 2024 Accepting new patients
Baylor College of Medicine CurrentSince Sep 1, 2024 Accepting new patients

Locations

1 Baylor Plz
#2
Houston, TX 77030

1919 Old Spanish Trl
Houston, TX 77054
Phone (713) 798-3750

1919 Old Spanish Trl
Fl 6
Houston, TX 77054
Phone (713) 798-3750

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

17450 St Lukes Way
Ste 340
The Woodlands, TX 77384
Phone (936) 266-2645

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.

Hospital & facility affiliations 1

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": "1488758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1467992719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 HAYES RD APT 734",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770826637",
            "telephone_number": "917-202-6310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 OLD SPANISH TRL",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770542003",
            "telephone_number": "713-798-4321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2828 Hayes Rd Apt 734",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770826637",
            "country_code": "US",
            "telephone_number": "917-202-6310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OJI",
        "first_name": "OMOBOLANLE",
        "middle_name": "MUTIAT",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-06",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP132168",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP132168",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "AP132168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.