Individual provider Active NPI

Taiwo Hassan Oguntade, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Saint Cloud, MN
National Provider Identifier
1053039818
Registry record updated Sep 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
9350 Issued in MN
Practice address
4180 Thielman LN Ste 100
Saint Cloud, MN 56301-4692
Phone
(320) 281-3154
NPI assigned
Aug 18, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 9350 MN Primary

Addresses

Primary practice location

4180 Thielman LN Ste 100
Saint Cloud, MN 56301-4692

Mailing address

4180 Thielman LN Ste 100
Saint Cloud, MN 56301-4692
Phone (320) 281-3154

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20221013000232 MN Practitioner - Nurse Practitioner 1557737772 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Saint Cloud, MN 56301
Phone (320) 237-6882

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stevens Community Medical Center Inc. Current Accepting new patients
Better Days Psychiatry LLC Psychiatric/Mental Health CurrentSince Aug 18, 2024 Accepting new patients
Stevens Community Medical Center Inc CurrentSince Sep 1, 2022 Accepting new patients
Stevens Community Medical Center Inc CurrentSince Sep 1, 2022 Accepting new patients

Locations

400 E 1st St
Morris, MN 56267
Phone (320) 589-1313

4180 Thielman Ln
Saint Cloud, MN 56301

4180 Thielman Ln
Ste 100
Saint Cloud, MN 56301
Phone (320) 237-6882

Organizations & group practices 4

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": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758931200000",
    "number": "1053039818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4180 THIELMAN LN STE 100",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014692",
            "telephone_number": "320-281-3154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4180 THIELMAN LN STE 100",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014692",
            "telephone_number": "320-281-3154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUNTADE",
        "first_name": "TAIWO",
        "middle_name": "HASSAN",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-18",
        "last_updated": "2025-09-27",
        "certification_date": "2025-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "9350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.