MARY OLUBUKOLA FAKUNLE
NPI 1134625874
Urology in Santa Monica, CA

Q: 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.

Q: What is Mary Fakunle's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Q: 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.

Active since April 02, 2018PECOS Enrolled

1260 15TH ST STE 1200, SANTA MONICA, CA 90404(310) 794-7700 Get Directions Write a Review

NPPES record last updated: July 2, 2024. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Jul 2, 2024, Jul 28, 2019 (2 updates tracked since 2019).

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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

NPI1134625874

Entity TypeIndividualFemale

Primary Taxonomy208800000X

Provider Legal NameMARY OLUBUKOLA FAKUNLE

Location Address1260 15TH ST STE 1200Santa Monica, CA 90404-1147

Mailing Address5767 W Century Blvd Ste 400Los Angeles, CA 90045-5631

Phone(310) 794-7700

Sole ProprietorNo

Medical School CMSRutgers New Jersey Medical SchoolGraduated 2018

Enumeration DateApril 2, 2018

Last NPPES UpdateJuly 2, 20242 updates tracked since enumeration

NPPES CertifiedJuly 2, 2024

✔ NPI 1134625874 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

License✔ Licensed in CA · A163588

Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

1260 15TH ST STE 1200, Santa Monica, CA 90404

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Secondary Practice Location 1

Location 1513 Parnassus Ave # S321San Francisco, CA 94143-2205 · Phone (415) 476-1239

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary Olubukola Fakunle is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4688006828

PECOS Enrollment IDI20240523003760

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 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.

New Patient

$142.39 typical visit price

range $62.96 – $187.60

Typical copayment $35.59 (range $15.74 – $46.90)

Most-billed visit code 99204

Established Patient

$77.96 typical visit price

range $20.84 – $153.61

Typical copayment $19.49 (range $5.21 – $38.40)

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 18

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

JOHN MICHAEL DELGADO MD

Family Medicine