Individual provider Active NPI

Olufunmilayo Olanipekun, DPM

  • Podiatrist
  • Inglewood, CA
National Provider Identifier
1497941306
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E4794 Issued in CA
Practice address
415 E Tamarack Ave
Unit 1
Inglewood, CA 90301-6300
Phone
(310) 412-2709
NPI assigned
Sep 25, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E4794 CA Primary

Addresses

Primary practice location

415 E Tamarack Ave
Unit 1
Inglewood, CA 90301-6300

Mailing address

415 E Tamarack Ave
Unit 1
Inglewood, CA 90301-6300
Phone (310) 412-2709

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090526000051 CA Practitioner - Podiatry 9638254568 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

9333 Rosecrans Ave
Bellflower, CA 90706-2141
Phone (562) 461-3000

9400 Rosecrans Ave
Bellflower, CA 90706-2246
Phone (562) 461-3000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Jul 19, 2016 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jul 19, 2016 Accepting new patients
County of Los Angeles CurrentSince May 10, 2010 Accepting new patients
County of Los Angeles Current Accepting new patients
County of Los Angeles Auditor Controller CurrentSince May 10, 2010 Accepting new patients
Mario a. Pacada, DPM, Inc Podiatrist Past Accepting new patients
Michael D. Kotzen, Inc. PastSince Sep 13, 2020 Accepting new patients

Locations

9400 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-6064

9333 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-3340

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303

Organizations & group practices 8

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": "1190678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1497941306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 E TAMARACK AVE",
            "address_2": "UNIT 1",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903016300",
            "telephone_number": "310-412-2709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 E TAMARACK AVE",
            "address_2": "UNIT 1",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903016300",
            "telephone_number": "310-412-2709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLANIPEKUN",
        "first_name": "OLUFUNMILAYO",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-25",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E4794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9400 Rosecrans Ave",
            "city": "Bellflower",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907062246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

Verify at the official NPI Registry.