DR. OLUWAMUYIWA BOLONDURO (M.D) – Obstetrics & Gynecology Physician, NPI 1215216965
Obstetrics & Gynecology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. OLUWAMUYIWA BOLONDURO (M.D)
742 W HIGHLAND AVE
SAN BERNARDINO, CA 924053839
Phone: (909) 881-7320
Fax: (909) 881-7330
Type: Mailing
5650 JILLSON ST
COMMERCE, CA 900401482
Phone: (323) 201-4516
Type: Mailing
45104 10TH ST W
LANCASTER, CA 93534
Phone: (562) 867-7999
Type: Location
1700 N Rose Ave Ste 280
Oxnard, CA 930307645
Phone: (805) 384-8071
Fax: (805) 278-6477
Type: Location
1600 N Rose Ave
Oxnard, CA 930303722
Phone: (805) 988-2500
Fax: (805) 256-7840
Type: Location
2309 Antonio Ave
Camarillo, CA 930101414
Phone: (805) 389-5800
Fax: (805) 256-7840
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $3,000.
Total Amount is formed as General ($3,000) + Research ($0) + Ownership ($0) = $3,000.
Last reported payment date: 2024-12-05 • Largest payer in this snapshot: Intuitive Surgical, Inc. ($3,000).
Total Amount
$3,000
General + Research + Ownership
Payments
2
Total payment records
General Amount
$3,000
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Intuitive Surgical, Inc. | $3,000 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2020-09-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20200924001235 | I | Obstetrics/Gynecology | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 92405)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O B S T E T R I C S/ G Y N E C O L O G Y | IN | |
| - | IN | |
| C H I R O P R A C T I C | IN | |
| - | IN | |
| E N D O C R I N O L O G Y | IN | |
| O B S T E T R I C S/ G Y N E C O L O G Y | IN | |
| Clinical Psychologist | IL | |
| O P T O M E T R Y | IL | |
| Family Practice | IN | |
| P O D I A T R Y | IL |
Reviews
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