ADELINE MEMORIAL MEDICAL GROUP PLLC
NPI 1760075667
Nurse Practitioner - Family in Rosenberg, TX
About Adeline Memorial Medical Group Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ADELINE MEMORIAL MEDICAL GROUP PLLC (NPI 1760075667) is a healthcare organization registered as a family in Rosenberg, Texas and active in the NPI registry since February 2021. The organization holds 2 active CLIA laboratory certificates, maintains a secondary practice location in Houston, and lists Funmilola O Odutayo, Provider, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Adeline Memorial Medical Group Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Adeline Memorial Medical Group PLLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA 2
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 45D2321316
Adeline Memorial Medical Group PLLC · Rosenberg, TXCertificate of Waiver 45D2321314
Adeline Memorial Medical Group PLLC · Houston, TXFrequently 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 Adeline Memorial Medical Group PLLC's NPI number?
The NPI number for Adeline Memorial Medical Group PLLC is 1760075667. It was assigned to this organization in the NPPES registry on February 11, 2021.
Where is Adeline Memorial Medical Group PLLC located?
Adeline Memorial Medical Group PLLC is located at 3200 Avenue I, Rosenberg, TX 77471. The listed phone number is (832) 344-3650.
What is Adeline Memorial Medical Group PLLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Adeline Memorial Medical Group PLLC enrolled in Medicare?
Yes. Adeline Memorial Medical Group PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Adeline Memorial Medical Group PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Adeline Memorial Medical Group PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Adeline Memorial Medical Group PLLC hold CLIA laboratory certificates?
Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
What insurance does Adeline Memorial Medical Group PLLC accept?
Health plans from WellPoint list Adeline Memorial Medical Group PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Adeline Memorial Medical Group PLLC was last updated on August 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Adeline Memorial Medical Group Pllc · NPI 1760075667
Family organization in Rosenberg, Texas. Organization record, active in the CMS NPPES registry since February 11, 2021.
## Identity
- **NPI:** 1760075667 (Entity type: Organization)
- **Enumerated:** February 11, 2021
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Funmilola Odutayo, PROVIDER
## Practice location
- **Address:** 3200 AVENUE I, Rosenberg, TX 77471-3630
- **Phone:** (832) 344-3650
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 6, 2025
- **CLIA laboratory certificates:** 2 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1760075667) · Data from the CMS NPPES public registry.