Individual provider Active NPI

Solomon Oluwatosin Badejoko, M.D.

  • Internal Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1811429012
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
U6443 Issued in TX
Practice address
900 8TH Ave
Fort Worth, TX 76104-3902
Phone
(817) 336-2100
NPI assigned
Mar 28, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 171226 CA
Pediatrics Physician 208000000X U6443 TX
Internal Medicine Physician 207R00000X U6443 TX Primary
Internal Medicine Physician 207R00000X 171226 CA

Addresses

Primary practice location

900 8TH Ave
Fort Worth, TX 76104-3902

Mailing address

13737 Noel Rd Ste 1600
Dallas, TX 75240-1374
Phone (954) 939-5000

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231016000565 TX Practitioner - Internal Medicine 1658616875 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lonestar Hospital Medicine Associates PAGroup PAC ID 6709049703, 126 clinicians

Practice addresses (Care Compare)

2700 E Broad St
Mansfield, TX 76063-5899
Phone (682) 622-2000

Hospital & facility affiliations

  • Methodist Midlothian Medical Center Hospital, Midlothian, TX, CCN 670300
  • Methodist Mansfield Medical Center Hospital, Mansfield, TX, CCN 670023

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
171226CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lonestar Hospital Medicine Associates, PA Internal Medicine CurrentSince Jan 1, 2025 Accepting new patients
Columbia Plaza Medical Center of Fort Worth Subsidiary LP Past Accepting new patients

Locations

3500 W Wheatland Rd
Dallas, TX 75237
Phone (214) 947-5950

2700 E Broad St
Mansfield, TX 76063
Phone (682) 242-2000

1201 E Highway 287
Midlothian, TX 76065
Phone (469) 695-2065

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

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 and National Provider Directory roles.

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": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1811429012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13737 NOEL RD STE 1600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752401374",
            "telephone_number": "954-939-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 8TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043902",
            "telephone_number": "817-336-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADEJOKO",
        "first_name": "SOLOMON",
        "middle_name": "OLUWATOSIN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-28",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "171226",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "U6443",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "U6443",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "171226",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.