MARY OLUBUKOLA FAKUNLE
NPI 1134625874
Urology in Santa Monica, CA
About Mary Olubukola Fakunle NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARY OLUBUKOLA FAKUNLE (NPI 1134625874) is an individual urology provider in Santa Monica, California, licensed in California (A163588) and active in the NPI registry since April 2018. She is enrolled in Medicare PECOS, maintains a secondary practice location in San Francisco, and is a graduate of Rutgers New Jersey Medical School (2018).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
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
Mary Olubukola Fakunle 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 90404 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 19
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SANTA MONICA, CA 90404
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mary Fakunle's NPI number?
The NPI number for Mary Fakunle is 1134625874. It was assigned to this individual provider in the NPPES registry on April 2, 2018.
Where is Mary Fakunle located?
Mary Fakunle practices at 1260 15th St Ste 1200, Santa Monica, CA 90404. The listed phone number is (310) 794-7700.
What is Mary Fakunle's specialty?
The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.
Is Mary Fakunle enrolled in Medicare?
Yes. Mary Fakunle is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
When was this NPI record last updated?
The NPPES record for Mary Fakunle was last updated on July 2, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.
# Mary Olubukola Fakunle · NPI 1134625874
Urology physician in Santa Monica, California. Individual provider, active in the CMS NPPES registry since April 2, 2018.
## Identity
- **NPI:** 1134625874 (Entity type: Individual)
- **Enumerated:** April 2, 2018
- **Primary specialty:** Urology · taxonomy 208800000X
- **State license:** A163588 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 1260 15TH ST STE 1200, Santa Monica, CA 90404-1147
- **Phone:** (310) 794-7700
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Rutgers New Jersey Medical School, class of 2018
## Record status
- **NPPES last updated:** July 2, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1134625874) · Data from the CMS NPPES public registry.