Individual provider Active NPI

Oluwadamilola A Ajasa

  • Certified Registered Nurse Anesthetist
  • Crown Point, IN
National Provider Identifier
1053284109
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209.033888 Issued in IL
Practice address
12750 Saint Francis Dr
Crown Point, IN 46307-0264
Phone
(219) 738-2100
NPI assigned
Sep 25, 2025
Last updated
Nov 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 209.033888 IL Primary

Addresses

Primary practice location

12750 Saint Francis Dr
Crown Point, IN 46307-0264

Mailing address

17961 Semmler Dr
Tinley Park, IL 60487-8655
Phone (708) 979-2759

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20251217000865 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 5496240566 Reassigns benefits to 1 organization
I20260430001713 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 5496240566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia of Illinois, LLCGroup PAC ID 4688893878, 404 clinicians
Northstar Anesthesia of Indiana LLCGroup PAC ID 1153576905, 130 clinicians

Practice addresses (Care Compare)

120 N Oak St
Hinsdale, IL 60521-3829
Phone (630) 856-9000

1423 Chicago Rd
Chicago Heights, IL 60411-3400
Phone (708) 756-1000

24 Joliet St
Dyer, IN 46311-1705
Phone (219) 865-2141

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.033888ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Indiana LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2025 Accepting new patients

Locations

12750 Saint Francis Dr
Crown Point, IN 46307
Phone (219) 738-2100

24 Joliet St
Dyer, IN 46311
Phone (219) 864-2237

Organizations & group practices 2

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1758758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1053284109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17961 SEMMLER DR",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604878655",
            "telephone_number": "708-979-2759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12750 SAINT FRANCIS DR",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463070264",
            "telephone_number": "219-738-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJASA",
        "first_name": "OLUWADAMILOLA",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-25",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209.033888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.