Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MICHAEL G OMOTOLA PA-C
NPI 1124505615
Physician Assistant in Addison, TX

Q: What is Michael Omotola's NPI number?

The NPI number for Michael Omotola is 1124505615. It was assigned to this individual provider in the NPPES registry on July 26, 2018.

Q: What is Michael Omotola's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Michael Omotola was last updated on August 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 41 days 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 July 26, 2018PECOS EnrolledAccepts Medicare Assignment

4135 BELT LINE RD STE 124, ADDISON, TX 75001(469) 495-9126(469) 495-0726 Get Directions Write a Review

NPPES record last updated: August 27, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Aug 27, 2026, Jul 26, 2018 (2 updates tracked since 2018).

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About Michael G Omotola Pa-c NPPES

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

MICHAEL G OMOTOLA PA-C (NPI 1124505615) is an individual physician assistant in Addison, Texas, licensed in Texas (PA12295) and active in the NPI registry since July 2018. He is enrolled in Medicare PECOS, maintains a secondary practice location in Grand Prairie, and is a graduate of Eastern Virginia Medical School (2018).

NPPES Registry Identity

NPI1124505615

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameMICHAEL G OMOTOLACredential: PA-C

Location Address4135 BELT LINE RD STE 124Addison, TX 75001-5879

Mailing Address417 W 20th St Unit 11386Norfolk, VA 23517-1287 · (512) 363-3257

Phone(469) 495-9126

Fax(469) 495-0726

Sole ProprietorNo

Medical School CMSEastern Virginia Medical SchoolGraduated 2018

Enumeration DateJuly 26, 2018

Last NPPES UpdateAugust 27, 20262 updates tracked since enumeration

NPPES CertifiedAugust 27, 2026

✔ NPI 1124505615 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in TX · PA12295

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

4135 BELT LINE RD STE 124, Addison, TX 75001

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Secondary Practice Location 1

Location 12520 W I 20Grand Prairie, TX 75052-7280 · Phone (512) 363-3257

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Michael G Omotola Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6103257548

PECOS Enrollment IDI20200519000618

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.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

56 services46 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

38 services38 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

28 services24 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza 87428

This test uses a method called immunoassay to identify severe acute respiratory syndrome coronavirus and influenza. It works by detecting specific proteins (antigens) in a sample, like a nasal swab. It's a powerful tool in diagnosing these viral infections.

24 services23 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

20 services20 patients

X-ray of chest, 2 views 71046

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

15 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75001 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

$71.28 typical visit price

range $18.48 – $141.20

Typical copayment $17.82 (range $4.62 – $35.30)

Most-billed visit code 99213

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.

SABITA SIGDEL FNP

Nurse Practitioner (Family)