Propercare Internal Medicine PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

K06009 Issued in TX

Legal business name

PROPERCARE INTERNAL MEDICINE PA

Practice address

2727 Bolton Boone Dr
Suite 102
Desoto, TX 75115-2019

Phone

(972) 283-8777

Fax

(972) 283-9333

NPI assigned

Dec 18, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Michael O Olatunji, MDNPI 1750303863

Title

Medical Director

Phone

(972) 283-8777

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Olubayo Idowu Md Pa Former legal business name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Olaleye Olatunji, M.D.

  • Internal Medicine Physician
  • Frisco, TX
  • NPI 1750303863
  Medicare reassignment NPD Authorized official
• Olubayo A Idowu, MD

  • Internal Medicine Physician
  • Desoto, TX
  • NPI 1891818399
  Medicare reassignment NPD
• Lindsay Michelle Wilson, APRN- FNP

  • Family Nurse Practitioner
  • Dallas, TX
  • NPI 1356821284
  Medicare reassignment NPD
• Mechiell Demetrius Tucker, PA

  • Physician Assistant
  • Desoto, TX
  • NPI 1730101783
  Medicare reassignment
• Funmilayo Akinjagunla, FNP

  • Family Nurse Practitioner
  • Fort Worth, TX
  • NPI 1609422567
  NPD (past)

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

{
    "created_epoch": "1261094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676332800000",
    "number": "1922337088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 BOLTON BOONE DR",
            "address_2": "SUITE 102",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152019",
            "telephone_number": "972-283-8777",
            "fax_number": "972-283-9333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 BOLTON BOONE DR",
            "address_2": "SUITE 102",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152019",
            "telephone_number": "972-283-8777",
            "fax_number": "972-283-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROPERCARE INTERNAL MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-18",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-01",
        "status": "A",
        "authorized_official_last_name": "OLATUNJI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "972-283-8777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K06009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "K06009",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "M1276",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Olubayo Idowu Md Pa",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Olubayo Idowu Md Pa",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Internal Medicine Physician in Desoto, TX
• Providers in Desoto, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.