Individual provider Active NPI

Latifat Omotayo Olafimihan, PT

  • Physical Therapist
  • Baytown, TX
National Provider Identifier
1548584097
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1302820 Issued in TX
Practice address
3818 Decker Dr
Baytown, TX 77520-1662
Phone
(281) 424-7557
Fax
(281) 424-7567
NPI assigned
Mar 25, 2010
Last updated
Apr 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1302820 TX Primary

Addresses

Primary practice location

3818 Decker Dr
Baytown, TX 77520-1662

Mailing address

14730 Jasper Stream CT
Houston, TX 77069-1562
Phone (301) 366-9315

Other practice location 1

11242 Fm 1960 Rd W Ste 104
Houston, TX 77065-3635
Phone (281) 469-8163

Other names 1

  • Latifat Omotayo Oladipo Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230110000307 TX Practitioner - Physical Therapist in Private Practice 5294956637 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Luna Care Physical Therapy LLCGroup PAC ID 0648692723, 271 clinicians

Practice addresses (Care Compare)

180 State St
Suite 225
Southlake, TX 76092-7632
Phone (866) 525-3175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1302820TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Life Physical Therapy LLC Physical Therapist CurrentSince Sep 20, 2022 Accepting new patients
Star Therapy Centers Limited Partnership Physical Therapist CurrentSince Apr 23, 2024 Accepting new patients
Texas Luna Care Physical Therapy LLC Physical Therapist CurrentSince Dec 22, 2022 Accepting new patients
Cabatherapy Services Physical Therapist CurrentSince Dec 10, 2023 Accepting new patients
Star Therapy Centers Limited Partnership Physical Therapist CurrentSince Apr 23, 2024 Accepting new patients
Star Therapy Centers Limited Partnership Physical Therapist Current Accepting new patients
Action Therapy Centers Limited Past Accepting new patients
Caba Therapy Services Physical Therapist PastSince Dec 10, 2023 Accepting new patients
Action Therapy Centers Limited Past Accepting new patients

Locations

3818 Decker Dr
Baytown, TX 77520

11242 FM 1960 Rd W
Ste 104
Houston, TX 77065
Phone (281) 469-8163

14550 Torrey Chase Blvd
Ste 110
Houston, TX 77014
Phone (281) 836-5985

4009 Bellaire Blvd
Ste M
Houston, TX 77025
Phone (713) 839-7800

180 State St
Ste 225
Southlake, TX 76092
Phone (682) 429-7066

Organizations & group practices 10

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": "1269475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1548584097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14730 JASPER STREAM CT",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770691562",
            "telephone_number": "301-366-9315",
            "fax_number": "281-424-7567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3818 DECKER DR",
            "city": "BAYTOWN",
            "state": "TX",
            "postal_code": "775201662",
            "telephone_number": "281-424-7557",
            "fax_number": "281-424-7567"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11242 Fm 1960 Rd W Ste 104",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770653635",
            "country_code": "US",
            "telephone_number": "281-469-8163",
            "fax_number": "281-469-5559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLAFIMIHAN",
        "first_name": "LATIFAT",
        "middle_name": "OMOTAYO",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-25",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1302820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LATIFAT",
            "last_name": "OLADIPO",
            "middle_name": "OMOTAYO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baytown, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.