Abisoye Ifaseyi Odutayo, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP121759 Issued in TX

Practice address

1201 S. Alen Genoa Rd
South Houston, TX 77587

Phone

(713) 910-0000

Fax

(713) 910-0004

NPI assigned

Jun 11, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Abisoye Odutayo Professional name

Medicare fee-for-service enrollment

Enrolled in TX

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 1

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Emergency Medical Doctors Services PLLC

  • Emergency Medicine Physician
  • Houston, TX
  • NPI 1811227150
  Medicare reassignment NPD
• Teni Home Health LLC

  • Home Health Agency
  • South Houston, TX
  • NPI 1518809136
  NPD Authorized official
• Toni Family Practice

  • Primary Care Clinic/Center
  • Houston, TX
  • NPI 1558737635
  NPD (past) Authorized official

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

{
    "created_epoch": "1370908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1679911747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 S. ALEN GENOA RD",
            "city": "SOUTH HOUSTON",
            "state": "TX",
            "postal_code": "77587",
            "telephone_number": "713-910-0000",
            "fax_number": "713-910-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S. ALEN GENOA RD",
            "city": "SOUTH HOUSTON",
            "state": "TX",
            "postal_code": "77587",
            "telephone_number": "713-910-0000",
            "fax_number": "713-910-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODUTAYO",
        "first_name": "ABISOYE",
        "middle_name": "IFASEYI",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-11",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "AP121759",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP121759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABISOYE",
            "last_name": "ODUTAYO",
            "credential": "FNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Stephanie Mendoza, MS, RDN, LD
• Mary Fathy Fawzy Morcos
• Radcliffe Myers, FNP-BC
• Michelle Nelson, ATC, LAT
• Nikorxpharmacy
• Pasadena Dental & Orthodontics PLLC
• Khairunissa Mehdi Pradhan, DDS
• Ramneek Rai, DDS
• Chelsie Nicole Ramirez
• Mehul Rana

• Family Nurse Practitioner in South Houston, TX
• Providers in South Houston, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; 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.