Ochuele Odumosu, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MT198875 Issued in PA

Practice address

420 Johnson Rd Ste 304
Keller, TX 76248-3463

Phone

(817) 710-3040

Fax

(989) 200-4650

NPI assigned

Oct 3, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Family Practice

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vine Family Medicine PLLCGroup PAC ID 9537563416, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Texas Health Harris Methodist Hospital Alliance Hospital, Fort Worth, TX, CCN 670085
• Baylor Scott & White Medical Center Grapevine Hospital, Grapevine, TX, CCN 450563

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ochuele.odumosu@txvifm.eclinicaldirectplus.com

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.

• Vine Family Medicine PLLC

  • Family Medicine Physician
  • Keller, TX
  • NPI 1407427420
  Medicare reassignment Care Compare group NPD Authorized official
• Neuropathy & Pain Centers of Texas PLLC

  • Adult Medicine Physician
  • Keller, TX
  • NPI 1902274186
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baylor Regional Medical Center at Grapevine

  • General Acute Care Hospital
  • Grapevine, TX
  • NPI 1073511762
  Care Compare affiliation
• Texas Health Harris Methodist Hospital Alliance

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1215296884
  Care Compare affiliation

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

{
    "created_epoch": "1317600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630972800000",
    "number": "1891079323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 JOHNSON RD STE 304",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762483463",
            "telephone_number": "817-710-3040",
            "fax_number": "989-200-4650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 JOHNSON RD STE 304",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762483463",
            "telephone_number": "817-710-3040",
            "fax_number": "989-200-4650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODUMOSU",
        "first_name": "OCHUELE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-03",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MT198875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NTSS North Texas Sleep Solutions LLC
• Nuhealth Pharmacy
• Oasis Dental, P.a.
• Sierra Ochekwu, LCSW
• Alissa Ochoa
• Oluwaseun Odumosu, MD
• Michalla Oldham
• Marshall A Olson, DDS
• Omar a. Gomez, M.D.,P.a.
• Optum Health & Sport Therapy

• Family Medicine Physician in Keller, TX
• Providers in Keller, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2021; 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.