Chukwuma Soyinka Osifeso, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

T3354 Issued in TX

Practice address

9900 N Central Expy Ste 215
Dallas, TX 75231-0929

Phone

(214) 396-4950

NPI assigned

Aug 16, 2011

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Regency Hospital of Minneapolis, LLC

  • Long Term Care Hospital
  • Golden Valley, MN
  • NPI 1770585382
  Medicare reassignment NPD
• Straightline Medical Consultants

  • Nephrology Physician
  • Dallas, TX
  • NPI 1487810164

  Internal Medicine

  NPD

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

{
    "created_epoch": "1313452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1659650091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 MEDICAL DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012130",
            "telephone_number": "903-595-5486",
            "fax_number": "903-595-5128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 N CENTRAL EXPY STE 215",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752310929",
            "telephone_number": "214-396-4950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1133 Medical Dr",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757012130",
            "country_code": "US",
            "telephone_number": "903-595-5486",
            "fax_number": "903-595-5128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OSIFESO",
        "first_name": "CHUKWUMA",
        "middle_name": "SOYINKA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-16",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-122832",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "57.019023",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "T3354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0101323",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Oluwatosin Oshoba
• Oshun Wellness Services, LLC
• Abiodun Osibamowo, MD
• Princess Osibodu
• Isaac Osiebo
• Fidelia Osifo-Selormey, CNP
• Adebola Osikoya, PMHNP
• Darshunda Osioh
• Jessica Osipenko, NP
• Anna Osipova, MS, BCBA, LBA

• Nephrology Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Nephrology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.