Individual provider Active NPI

Olayemi Omotosho, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Katy, TX
National Provider Identifier
1033800503
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1119120 Issued in TX
Practice address
2340 Texas Heritage Pkwy Ste 700
Katy, TX 77494-4637
Phone
(346) 287-6006
NPI assigned
May 16, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 295134 AZ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1119120 TX Primary

Addresses

Primary practice location

2340 Texas Heritage Pkwy Ste 700
Katy, TX 77494-4637

Mailing address

2340 Texas Heritage Pkwy Ste 700
Katy, TX 77494-4637
Phone (346) 287-6006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ, AZ, TX4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20231017002767 NY Practitioner - Nurse Practitioner 6800241472 Reassigns benefits to 2 organizations
I20241031000564 NJ Practitioner - Nurse Practitioner 6800241472 Reassigns benefits to 2 organizations
I20260227001066 AZ Practitioner - Nurse Practitioner 6800241472 Reassigns benefits to 1 organization
I20260408001313 TX Practitioner - Nurse Practitioner 6800241472 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Womens Health Group LLCGroup PAC ID 2961316328, 352 clinicians

Practice addresses (Care Compare)

2401 Evesham Rd a
Garden State OB GYN
Voorhees, NJ 08043-9590
Phone (856) 424-3323

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
295134AZMDPsychiatric/Mental Health Nurse Practitioner
1119120TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aldad Medical PC CurrentSince Nov 1, 2023 Accepting new patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Jun 25, 2024 Accepting new patients
Regional Womens Health Group LLC CurrentSince Nov 1, 2024 Accepting new patients
Regional Women'S Health Group, LLC CurrentSince Nov 1, 2024 Accepting new patients
Linq Care Medical Provider, LLC. CurrentSince Mar 8, 2025 Accepting new patients

Locations

4600 E Washington St
Ste 300
Phoenix, AZ 85034
Phone (602) 638-1872

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

50 S Main St
Ste 200
Naperville, IL 60540
Phone (312) 961-4490

971 US Highway 202 N
Ste R
Branchburg, NJ 08876
Phone (631) 987-4632

525 Route 73 N
Ste 104
Marlton, NJ 08053
Phone (856) 433-7222

188 Fries Mill Rd
Ste N1
Turnersville, NJ 08012
Phone (609) 261-7023

2401 E Evesham Rd
Ste A
Voorhees, NJ 08043
Phone (856) 424-3323

227 Laurel Rd
Ste 300
Voorhees, NJ 08043
Phone (856) 669-6025

165 Broadway
Fl 23
New York, NY 10006
Phone (202) 972-4964

27111 76th Ave
North New Hyde Pk, NY 11040
Phone (718) 289-2100

510 Hempstead Tpke
Rm 203
West Hempstead, NY 11552
Phone 51650572001051

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1684195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1033800503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2340 TEXAS HERITAGE PKWY STE 700",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774944637",
            "telephone_number": "346-287-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2340 TEXAS HERITAGE PKWY STE 700",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774944637",
            "telephone_number": "346-287-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMOTOSHO",
        "first_name": "OLAYEMI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-16",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "295134",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1119120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.