Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Olusegun Bodunrin Ayadi Jr., PT, DPT, CSCS

Individual provider Physical Therapist · NPI 1639783442

Olusegun Bodunrin Ayadi Jr., PT, DPT, CSCS is a Physical Therapist in Private Practice in Tyler, Texas. Qualified in 2020, 6 years ago. Practices with Meredith S. Tittle, PT, LLC, a 22-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
6
Licensed in
TX
In the registry since
2020
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

751 S Beckham Ave
Tyler, TX 75701-1903
Phone: (903) 707-8099
Fax: (903) 258-9194
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 1337885 (TX)

Record details

NPI number1639783442
Entity typeIndividual (Type 1)
GenderMale
Credentials PT , DPT , CSCS
Sole proprietorNo
NPI enumeratedAugust 31, 2020
Last updated in NPPESSeptember 8, 2023
Certification dateSeptember 8, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Meredith S. Tittle, P.T., Llc — 22 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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