Omobukola Olayiwade Itua, RVT

Primary specialty

Vascular Sonography Radiologic TechnologistTaxonomy code 2471V0105X

License

147925 Issued in NJ

Practice address

4 Skyline Dr
Hazlet, NJ 07730-1679

Phone

(732) 910-2894

NPI assigned

Oct 1, 2025

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Specialty

Undefined Non-Physician Type (Specify)

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Goodland TLC Home Health Agency

  • Vascular Sonography Radiologic Technologist
  • Hazlet, NJ
  • NPI 1376417659

  Single Specialty

  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1759276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1003780388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 SKYLINE DR",
            "city": "HAZLET",
            "state": "NJ",
            "postal_code": "077301679",
            "telephone_number": "732-910-2894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 SKYLINE DR",
            "city": "HAZLET",
            "state": "NJ",
            "postal_code": "077301679",
            "telephone_number": "732-910-2894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ITUA",
        "first_name": "OMOBUKOLA",
        "middle_name": "OLAYIWADE",
        "name_prefix": "Mrs.",
        "credential": "RVT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-01",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471V0105X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiologic Technologist, Vascular Sonography",
            "state": "NJ",
            "license": "147925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Immediate Care Medical Walk-in of Hazlet, PA
• Inner Clarity Counseling
• Inner Clarity LLC
• Institute for Psychological and Spiritual Growth Inc
• Intuitive Behavioral, Inc
• Gail Jackapino, RPH
• Gerald Jackapino, RPH
• Asha Jain, M.D.
• Taylor Jefferson, LCSW
• Jeffrey S. Sachs, D.M.D., P.C.

• Vascular Sonography Radiologic Technologist in Hazlet, NJ
• Providers in Hazlet, NJ by specialty
• Vascular Sonography Radiologic Technologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.