Individual provider Active NPI

Eniola Aina Osifeso, APRN CNP

  • Family Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1831779040
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
200335 Issued in OK
Practice address
1120 S Utica Ave
Tulsa, OK 74104-4012
Phone
(918) 579-1000
NPI assigned
Apr 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 200335 OK Primary

Addresses

Primary practice location

1120 S Utica Ave
Tulsa, OK 74104-4012

Mailing address

4608 W Pittsburg St
Broken Arrow, OK 74012-5967
Phone (918) 269-1260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20240205000304 OK Practitioner - Nurse Practitioner 8123461480 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Omni Medical Group IncGroup PAC ID 9739080490, 82 clinicians

Practice addresses (Care Compare)

8115 S Memorial Dr
Tulsa, OK 74133-4331
Phone (918) 254-6315

Hospital & facility affiliations

  • Ascension St John Medical Center Hospital, Tulsa, OK, CCN 370114
  • Ascension St John Broken Arrow Hospital, Broken Arrow, OK, CCN 370235

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Enix Family Health Clinic CurrentSince Mar 1, 2026 Accepting new patients
Omni Medical Group Inc CurrentSince Feb 22, 2024 Accepting new patients

Locations

8115 S Memorial Dr
Tulsa, OK 74133
Phone (918) 254-6315

9920 E 21st St
Tulsa, OK 74129
Phone (918) 999-9999

1923 S Utica Ave
Ofc
Tulsa, OK 74104

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

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 3

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": "1618185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1831779040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4608 W PITTSBURG ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740125967",
            "telephone_number": "918-269-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044012",
            "telephone_number": "918-579-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSIFESO",
        "first_name": "ENIOLA",
        "middle_name": "AINA",
        "credential": "APRN CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-12",
        "last_updated": "2021-04-12",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "200335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.