Active NPI
Bolarinwa Francis Olusola, MD
- Gastroenterology Physician
- Tyler, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- K6200
- Practice address
- 11937 US Highway 271
Tyler, TX 75708-3154 - Phone
- (903) 877-7777
- NPI assigned
- Oct 21, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | K6200 | TX | Primary |
Addresses
Primary practice location
11937 US Highway 271
Tyler, TX 75708-3154
Mailing address
PO Box 731912
Dallas, TX 75373-1912
Phone (903) 877-7777
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 145811901 | Medicaid | TX |
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100108000224 | TX | Practitioner - Gastroenterology | 3870679749 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Gastroenterology
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- University of Texas Health Science Center at Tyler-Facilty-Physician
Practice addresses (Care Compare)
11937 US Hwy 271
Tyler, TX 75708-3154
Phone (903) 877-7200
Hospital & facility affiliations
- University of Texas Health Science Center at Tyler
- Ut Health East Texas Tyler Regional Hospital
- Ut Health East Texas Athens Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 217 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 264 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Texas Health Science Center at Tyler-Facilty-Physician | Current | Accepting new patients | |
| University of Texas Health Science Center at Tyler-Facility-Physician | Current | Accepting new patients | |
| Northeast Texas Public Health District | Past | Accepting new patients |
Locations
102 W Henderson St
Overton, TX 75684
Phone (903) 834-0201
11937 US Highway 271
Tyler, TX 75708
Phone (903) 877-3451
1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068
Interoperability endpoints
- bolusola355569@ahs.direct-ci.com
Organizations & group practices 4
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.
-
- Sports Medicine (Neuromusculoskeletal Medicine) Physician
- Tyler, TX
- NPI 1063400778
TX
-
- Rural Health Clinic/Center
- Overton, TX
- NPI 1689496812
-
- State or Local Public Health Clinic/Center
- Tyler, TX
- NPI 1679150445
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Tyler, TX
- NPI 1417941295
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476662400000",
"number": "1790775724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 731912",
"city": "DALLAS",
"state": "TX",
"postal_code": "753731912",
"telephone_number": "903-877-7777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11937 US HIGHWAY 271",
"city": "TYLER",
"state": "TX",
"postal_code": "757083154",
"telephone_number": "903-877-7777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLUSOLA",
"first_name": "BOLARINWA",
"middle_name": "FRANCIS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-21",
"last_updated": "2016-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "TX",
"license": "K6200",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "145811901",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; 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.