NPIMap

Individual provider Active NPI

Oluwabukola Christiana Olatubosun, MD

  • Surgical Critical Care Physician
  • Charlotte, NC
National Provider Identifier
1659790707
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
2024-00248 Issued in NC
Practice address
10650 Park Rd
Ste 480 a
Charlotte, NC 28210-8538
Phone
(704) 355-1813
NPI assigned
Apr 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2024-00248 NC
Surgical Critical Care Physician 2086S0102X 2024-00248 NC Primary

Addresses

Primary practice location

10650 Park Rd
Ste 480 a
Charlotte, NC 28210-8538

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 446-1255

Other practice location 2

1100 Healing Way
Ste 11A
Matthews, NC 28104-5159
Phone (980) 993-1745

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address oolatubosun2877995@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200918000662 WV Practitioner - General Surgery 5890113179 Reassigns benefits to 1 organization
I20240506004421 NC Practitioner - General Surgery 5890113179 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Texas Medical Branch at Galveston, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians
Carolinas Medical CenterGroup PAC ID 4789597477, 1,057 clinicians

Practice addresses (Care Compare)

10650 Park Rd
Suite 480
Charlotte, NC 28210-8538
Phone (704) 667-0520

1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 355-7328

920 Church St N
Concord, NC 28025-2927
Phone (704) 403-1632

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2024-00248NCMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Jun 23, 2025 Accepting new patients
Raleigh General Hospital LLC CurrentSince Oct 1, 2020 Accepting new patients
Carolinas Physicians Network Inc Surgery CurrentSince Apr 1, 2024 Accepting new patients
Carolinas Medical Center CurrentSince Apr 1, 2024 Accepting new patients
Raleigh General Hospital LLC Surgery CurrentSince Oct 1, 2020 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Apr 1, 2024 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Jun 23, 2025 Accepting new patients
Carolinas Medical Center Current Accepting new patients
Carolinas Medical Center Surgical Critical Care CurrentSince Apr 1, 2024 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network, Inc Past Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

1350 S Kings Dr
Charlotte, NC 28207
Phone (704) 446-1255

10650 Park Rd
Ste 480
Charlotte, NC 28210
Phone (704) 355-1813

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

200 Medical Park Dr
Ste 250
Concord, NC 28025
Phone (704) 403-2740

920 Church St N
Concord, NC 28025
Phone (704) 403-3000

1100 Healing Way
Ste 11A
Matthews, NC 28104
Phone (980) 993-1745

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

1717 Harper Rd
Ste 2G
Beckley, WV 25801

1710 Harper Rd
Beckley, WV 25801
Phone (304) 252-0641

1717 Harper Rd
Fl 2
Beckley, WV 25801
Phone (304) 461-3877

1717 Harper Rd
Ste 2E
Beckley, WV 25801

Interoperability endpoints

  • Direct secure messaging: oluwabukola.olatubosun@wvafn.hcadirect.net
  • Direct secure messaging: oolatubosun2877995@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 12

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.

Hospital & facility affiliations 10

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": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1659790707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10650 PARK RD",
            "address_2": "STE 480 A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108538",
            "telephone_number": "704-355-1813"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1350 S Kings Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282072134",
            "country_code": "US",
            "telephone_number": "704-446-1255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Healing Way",
            "address_2": "Ste 11A",
            "address_purpose": "LOCATION",
            "city": "Matthews",
            "state": "NC",
            "postal_code": "281045159",
            "country_code": "US",
            "telephone_number": "980-993-1745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLATUBOSUN",
        "first_name": "OLUWABUKOLA",
        "middle_name": "CHRISTIANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-15",
        "last_updated": "2024-07-15",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2024-00248",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NC",
            "license": "2024-00248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "oolatubosun2877995@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "10650 Park Rd",
            "address_2": "Ste 480 A",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282108538",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.