MICHAEL G OMOTOLA (PA-C) – Physician Assistant, NPI 1124505615
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,491 PHYSICIAN ASSISTANT in TX
Provider Addresses for MICHAEL G OMOTOLA (PA-C)
417 W 20TH ST UNIT 11386
NORFOLK, VA 235171287
Phone: (512) 363-3257
Type: Mailing
2520 W I 20
GRAND PRAIRIE, TX 750527280
Phone: (512) 363-3257
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $21.
Total Amount is formed as General ($21) + Research ($0) + Ownership ($0) = $21.
Last reported payment date: 2024-10-03 • Largest payer in this snapshot: PFIZER INC. ($21).
Total Amount
$21
General + Research + Ownership
Payments
1
Total payment records
General Amount
$21
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-03
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| PFIZER INC. | $21 |
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: 2020-05-19
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 |
|---|---|---|---|---|
| I20200519000618 | I | Physician Assistant | 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 | 88 | 64 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 61 | 61 | $0 |
| 87428 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza | 48 | 45 | $0 |
| 81002 | Urinalysis, manual test | 20 | 17 | $0 |
| 87880 | Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) | 16 | 16 | $0 |
Insurance plans in this area (ZIP 23517)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MO | |
| - | TX | |
| - | TX | |
| Physician Assistant | NY | |
| Nurse Practitioner | TX | |
| Physician Assistant | TX | |
| Nurse Practitioner | TX | |
| Physician Assistant | TX | |
| Family Practice | TX | |
| Physician Assistant | PA |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.