Individual provider Active NPI

Tolulope Adufe Sodimu, PA-C

  • Physician Assistant
  • Spring, TX
National Provider Identifier
1699377655
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA13997 Issued in TX
Practice address
2255 E Mossy Oaks Rd Ste 320
Spring, TX 77389-1812
Phone
(936) 266-2195
NPI assigned
Nov 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA13997 TX Primary

Addresses

Primary practice location

2255 E Mossy Oaks Rd Ste 320
Spring, TX 77389-1812

Mailing address

22710 Professional Dr Ste 202
Kingwood, TX 77339-6009
Phone (281) 312-8521

Other practice location 1

18532 Kuykendahl Rd
Spring, TX 77379-8160
Phone (713) 804-5961

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20201215003047 TX Practitioner - Physician Assistant 4082026042 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baylor St. Luke's Medical GroupGroup PAC ID 9133213192, 172 clinicians

Practice addresses (Care Compare)

20207 Chasewood Park Dr
Houston, TX 77070-1442

2255 E Mossy Oaks Rd
Spring, TX 77389-1812

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
East Texas Clinical Services Inc PastSince Aug 17, 2025 Accepting new patients

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1605225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1699377655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22710 PROFESSIONAL DR STE 202",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773396009",
            "telephone_number": "281-312-8521",
            "fax_number": "281-359-7971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 E MOSSY OAKS RD STE 320",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773891812",
            "telephone_number": "936-266-2195"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18532 Kuykendahl Rd",
            "address_purpose": "LOCATION",
            "city": "Spring",
            "state": "TX",
            "postal_code": "773798160",
            "country_code": "US",
            "telephone_number": "713-804-5961",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SODIMU",
        "first_name": "TOLULOPE",
        "middle_name": "ADUFE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-13",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA13997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring, TX

Sources for this page

Verify at the official NPI Registry.