Adeline Memorial Medical Group PLLC
NPI 1760075667ActiveOrganization· Nurse Practitioner, Family· Rosenberg, TX
Nurse Practitioner, Family in Rosenberg, Texas, registered in NPPES in February 2021. The authorized official on file is Funmilola O. Odutayo, FNP, Provider. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1760075667 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 11, 2021 |
| Last updated in NPPES | Aug 6, 2025 |
| Certified by provider | Aug 6, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | — | — |
| Pediatrics | 208000000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (TX) |
|---|
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