Olasumbo Oladeru

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ00987800 Issued in NJ

Practice address

1901 N Olden Avenue Ext Ste 11a
Ewing, NJ 08618-2100

Phone

(609) 583-4970

Fax

(609) 323-7385

NPI assigned

Nov 20, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NJ, NY2 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 2

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Iconichealth LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Ewing, NJ
  • NPI 1972106292

  NJ, Psychiatric/Mental Health

  Medicare reassignment NPD Authorized official
• Cognicare Psychological Services LLC

  • Mental Health Counselor
  • Branchburg, NJ
  • NPI 1831746957

  NJ

  Medicare reassignment NPD
• Grow Healthcare Group of New Jersey PC

  • Mental Health Counselor
  • Hoboken, NJ
  • NPI 1841949328

  NJ

  Medicare reassignment
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  NY

  Medicare reassignment
• Cognicare Psychological Services LLC

  • Clinical Psychologist
  • Branchburg, NJ
  • NPI 1710726344
  NPD

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

{
    "created_epoch": "1574208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769558400000",
    "number": "1083250484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 N OLDEN AVENUE EXT STE 11A",
            "city": "EWING",
            "state": "NJ",
            "postal_code": "086182100",
            "telephone_number": "609-583-4970",
            "fax_number": "609-323-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 N OLDEN AVENUE EXT STE 11A",
            "city": "EWING",
            "state": "NJ",
            "postal_code": "086182100",
            "telephone_number": "609-583-4970",
            "fax_number": "609-323-7385"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4 Boleyn Ct",
            "address_purpose": "LOCATION",
            "city": "Ewing",
            "state": "NJ",
            "postal_code": "086282231",
            "country_code": "US",
            "telephone_number": "609-321-0233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLADERU",
        "first_name": "OLASUMBO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-20",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00987800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0751171",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "desktop",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1901 N Olden Avenue Ext Ste 11A",
            "city": "Ewing",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "086182100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Chinyere Nora Ogbonna
• Nevolia Ogletree, LMFT
• Kafilat Ojo, M.D
• Ijeoma Adamma Okeke, APN
• Illiona Okereke
• Olivia Van Wagner, LLC
• One Heaven Inc
• Kudirat A Onitiri, ED.S, LCADC, LMFT
• Onward Support Care Services
• Ogechi Nwakego Opara, APN

• All providers in Ewing, NJ
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2026; 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.