Patti Burk Olusola, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

L3595 Issued in TX

Practice address

11937 US Highway 271
Tyler, TX 75708-3154

Phone

(903) 877-7777

Fax

(903) 877-5080

NPI assigned

Oct 12, 2005

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

Other identifiers 1

Other names 1

• Patti Lynn Burk Former name

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

Texas Tech University Health Science Center School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Texas Health Science Center at Tyler-Facilty-PhysicianGroup PAC ID 4981699220, 118 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Texas Health Science Center at Tyler Hospital, Tyler, TX, CCN 450690
• Ut Health East Texas Tyler Regional Hospital Hospital, Tyler, TX, CCN 450083
• Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: polusola355570@ahs.direct-ci.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.

• University of Texas Health Science Center at Tyler-Facility-Physician

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Tyler, TX
  • NPI 1063400778

  TX

  Medicare reassignment Care Compare group NPD
• University of Texas Health Science Center at Tyler-Facilty-Physician

  • Rural Health Clinic/Center
  • Overton, TX
  • NPI 1689496812
  Care Compare group NPD
• East Texas Medical Center Healthcare Associates

  • Emergency Medicine Physician
  • Tyler, TX
  • NPI 1326082892
  NPD (past)

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

• Mother Frances Hospital Regional Health Care Center

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1679578439

  Hospital

  Care Compare affiliation
• Tyler Regional Hospital LLC

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1407364847

  Hospital

  Care Compare affiliation
• University of Texas Health Science Center at Tyler

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1417941295

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475625600000",
    "number": "1962490953",
    "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",
            "fax_number": "903-877-5080"
        },
        {
            "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",
            "fax_number": "903-877-5080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLUSOLA",
        "first_name": "PATTI",
        "middle_name": "BURK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-12",
        "last_updated": "2016-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L3595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153803501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATTI",
            "last_name": "BURK",
            "middle_name": "LYNN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lloyd M Olsen, MD
• Melinda Olson, MED, CCC SLP
• Aleksandra Olsson-Detwiler, M.D.
• Olsv3 PLLC
• Bolarinwa Francis Olusola, MD
• Addason Romana Olvera
• Ana Patrisia Olvera, C.O.T.A.
• David Adrian Olvera, MD
• Diana Olvera
• Oncology Pharmacy Services Inc

• All providers in Tyler, TX
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.

Verify at the official NPI Registry.