IBIDUNNI OMOLAYO UKEGBU (MD) – Internal Medicine Physician, NPI 1447213194
Internal Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
13,290 INTERNAL MEDICINE in TX
Provider Addresses for IBIDUNNI OMOLAYO UKEGBU (MD)
2727 BOLTON BOONE DR STE 103
DESOTO, TX 751152019
Phone: (469) 257-3500
Fax: (469) 449-0286
Type: Mailing
3506 21ST ST STE 401
LUBBOCK, TX 794101200
Phone: (469) 257-3500
Fax: (806) 723-7137
Type: Location
2727, Bolton Boone Drive, DeSoto, Dallas County, Texas, 75115, United States
STE 103
DESOTO, TX 751152019
Phone: (469) 453-2008
Fax: (469) 449-0286
Type: Mailing
3506, 21st Street, Lubbock, Texas, 79410, United States
STE 401
LUBBOCK, TX 79410
Phone: (806) 725-4130
Fax: (806) 723-7137
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 13 Open Payments records for all available years, with a total value of $208.
Total Amount is formed as General ($208) + Research ($0) + Ownership ($0) = $208.
Last reported payment date: 2024-12-16 • Largest payer in this snapshot: Lilly USA, LLC ($103).
Total Amount
$208
General + Research + Ownership
Payments
13
Total payment records
General Amount
$208
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-16
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2004-09-14
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 |
|---|---|---|---|---|
| I20040914000544 | I | Internal Medicine | TX | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 56 | 16 | $0 |
Insurance plans in this area (ZIP 75115)
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