Olabamiji Kazeem Abimbola, DSC, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA13372 Issued in TX

Practice address

4500 S Lancaster Rd
Dallas, TX 75216-7167

Phone

(401) 365-0464

NPI assigned

Jun 12, 2018

Last updated

Dec 21, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MA, TX, NY, CA4 enrollments

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 4

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Texas Post Acute Specialists, PAGroup PAC ID 9234407255, 3 clinicians

Chess Medical PCGroup PAC ID 5496126914, 12 clinicians

Post Acute Specialists of Massachusetts PLLCGroup PAC ID 0244640498, 49 clinicians

Post Acute Specialists LLCGroup PAC ID 1951676568, 180 clinicians

Tapestry Telehealth PLLCGroup PAC ID 4789942335, 80 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Umass Memorial Medical Center/University Campus Hospital, Worcester, MA, CCN 220163
• Mission Care at Holyoke Nursing home, Holyoke, MA, CCN 225480
• St Camillus Residential Health Care Facility Nursing home, Syracuse, NY, CCN 335283
• Holden Rehabilitation & Nursing Center Nursing home, Holden, MA, CCN 225002
• Notre Dame Long Term Care Center Nursing home, Worcester, MA, CCN 225577
• Oakdale Rehabilitation & Skilled Nursing Center Nursing home, West Boylston, MA, CCN 225334

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: oabimbola45910@direct.southcoast.org

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.

• Chess Medical, P.C.

  dba Tapestry Telehealth California

  • Internal Medicine Physician
  • Pleasanton, CA
  • NPI 1194315564
  Medicare reassignment Care Compare group NPD
• Texas Post Acute Specialists, PA

  • Internal Medicine Physician
  • Balch Springs, TX
  • NPI 1609314392
  Medicare reassignment Care Compare group
• Post Acute Specialists of Massachusetts PLLC

  • Internal Medicine Physician
  • Taunton, MA
  • NPI 1104438480
  Medicare reassignment Care Compare group
• Post Acute Specialists, LLC

  • Internal Medicine Physician
  • Naperville, IL
  • NPI 1114441565

  NY

  Medicare reassignment Care Compare group
• Tapestry Telehealth PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Chillicothe, OH
  • NPI 1992215446

  TX

  Medicare reassignment Care Compare group
• Emkayho Homes LLC

  • Community/Behavioral Health Agency
  • Mansfield, TX
  • NPI 1003496076
  NPD Authorized official
• Southcoast Physicians Group, Inc.

  • Family Medicine Physician
  • Fairhaven, MA
  • NPI 1336137629
  Medicare reassignment NPD (past)
• Ca Post Acute Specialists PC

  • Family Medicine Physician
  • Redding, CA
  • NPI 1710401302
  Medicare reassignment
• Southcoast Physicians Group, Inc.

  dba Southcoast Urgent Care Center

  • Emergency Medicine Physician
  • Fairhaven, MA
  • NPI 1861830143
  NPD
• Southcoast Physicians Group, Inc.

  • Orthopaedic Surgery Physician
  • North Dartmouth, MA
  • NPI 1902201536
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Holden Nursing Home, Inc

  • Skilled Nursing Facility
  • Holden, MA
  • NPI 1871588608

  Nursing home

  Care Compare affiliation
• Holyoke Care Center, LLC

  • Skilled Nursing Facility
  • Holyoke, MA
  • NPI 1255945325

  Nursing home

  Care Compare affiliation
• Notre Dame Health Care Center,Inc

  • Skilled Nursing Facility
  • Worcester, MA
  • NPI 1396736930

  Nursing home

  Care Compare affiliation
• St. Camillus Residential Health Care Facility

  • Skilled Nursing Facility
  • Syracuse, NY
  • NPI 1659396943

  Nursing home

  Care Compare affiliation
• St. Camillus Residential Health Care Facility

  • Multi-Specialty Clinic/Center
  • Syracuse, NY
  • NPI 1942341532

  Nursing home

  Care Compare affiliation
• Umass Memorial Medical Center, Inc.

  • General Acute Care Hospital
  • Worcester, MA
  • NPI 1831151455
  Care Compare affiliation
• West Boylston Nursing Home Inc

  dba Oakdale Rehabilitation and Skilled Nursing Center

  • Skilled Nursing Facility
  • West Boylston, MA
  • NPI 1972599124

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1619460938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 S LANCASTER RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752167167",
            "telephone_number": "401-365-0464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 S LANCASTER RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752167167",
            "telephone_number": "401-365-0464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Department of Surgery",
            "address_2": "113 Holland Ave",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "12208",
            "country_code": "US",
            "telephone_number": "401-365-0464",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "363 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Fall River",
            "state": "MA",
            "postal_code": "027203703",
            "country_code": "US",
            "telephone_number": "508-973-1020",
            "fax_number": "508-973-1025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABIMBOLA",
        "first_name": "OLABAMIJI",
        "middle_name": "KAZEEM",
        "name_prefix": "Dr.",
        "credential": "DSC, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-12",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA6600",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA13372",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "PA6600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "oabimbola45910@direct.southcoast.org",
            "affiliation": "N",
            "endpointDescription": "Southcoast Health Epic Direct Address",
            "address_1": "363 Highland Ave",
            "city": "Fall River",
            "state": "MA",
            "country_code": "US",
            "postal_code": "027203703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Ability Solutions Career College (Ability Solutions Career Center)
• Abiodun O Durojaiye (Camad Medical Supplies)
• Bamidele Olufisayo Abiona, PMHNP-BC
• Hamed A Abioye
• Olalekan Taofiki Abioye, PHARMD
• Abitol Micro-Med Corporation

• Medical Physician Assistant in Dallas, TX
• Providers in Dallas, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.