MODUPE OLUWATOYIN IDOWU
NPI 1104680255
Nurse Practitioner - Psychiatric/Mental Health in Grand Prairie, TX

Q: What is Modupe Idowu's NPI number?

The NPI number for Modupe Idowu is 1104680255. It was assigned to this individual provider in the NPPES registry on February 9, 2024.

Q: What is Modupe Idowu's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Modupe Idowu was last updated on April 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 09, 2024PECOS Enrolled

1801 S CARRIER PKWY, GRAND PRAIRIE, TX 75051(972) 433-0088(972) 730-9801 Get Directions Write a Review

NPPES record last updated: April 28, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 28, 2026, Feb 9, 2024 (2 updates tracked since 2024).

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About Modupe Oluwatoyin Idowu NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MODUPE OLUWATOYIN IDOWU (NPI 1104680255) is an individual psychiatric/mental health provider in Grand Prairie, Texas, licensed in Texas (1124176) and active in the NPI registry since February 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1104680255

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameMODUPE OLUWATOYIN IDOWU

Location Address1801 S CARRIER PKWYGrand Prairie, TX 75051-3702

Mailing Address7305 Aster DrVenus, TX 76084-3776 · (130) 180-6611

Phone(972) 433-0088

Fax(972) 730-9801

Sole ProprietorYes

Medical School CMSOtherGraduated 2023

Enumeration DateFebruary 9, 2024

Last NPPES UpdateApril 28, 20262 updates tracked since enumeration

NPPES CertifiedApril 28, 2026

✔ NPI 1104680255 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in TX · 1124176

1801 S CARRIER PKWY, Grand Prairie, TX 75051

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Modupe Oluwatoyin Idowu is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1658847595

PECOS Enrollment IDI20260417000845

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75051 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$88.19 typical visit price

range $57.18 – $172.86

Typical copayment $22.04 (range $14.29 – $43.21)

Most-billed visit code 99203

Established Patient

$100.80 typical visit price

range $18.48 – $141.20

Typical copayment $25.20 (range $4.62 – $35.30)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELVIS NGYIA PHD, NP-C, PMHNP-C

Nurse Practitioner (Psychiatric/Mental Health)