Individual provider Active NPI

Juliana Mobisola Okon

  • Psychiatric/Mental Health Registered Nurse
  • Hyde Park, MA
National Provider Identifier
1083323919
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
RN2317197 Issued in MA
Practice address
1 Dietz CT # a
Hyde Park, MA 02136-1108
Phone
(857) 249-7333
NPI assigned
Nov 18, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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 Registered Nurse 163WP0808X RN2317197 MA Primary

Addresses

Primary practice location

1 Dietz CT # a
Hyde Park, MA 02136-1108

Mailing address

1 Dietz CT
Hyde Park, MA 02136-1108
Phone (857) 249-7333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20230927003538 MA Practitioner - Nurse Practitioner 6709230592 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
Uhs of Westwood Pembroke IncGroup PAC ID 6204740947, 8 clinicians

Practice addresses (Care Compare)

199 Oak St
Pembroke, MA 02359-1912
Phone (781) 829-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mobis Health CurrentSince Nov 20, 2022 Accepting new patients
Uhs of Westwood Pembroke Inc CurrentSince Aug 14, 2023 Accepting new patients

Locations

199 Oak St
Pembroke, MA 02359
Phone (781) 829-7000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1668729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1083323919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DIETZ CT",
            "city": "HYDE PARK",
            "state": "MA",
            "postal_code": "021361108",
            "telephone_number": "857-249-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DIETZ CT # A",
            "city": "HYDE PARK",
            "state": "MA",
            "postal_code": "021361108",
            "telephone_number": "857-249-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKON",
        "first_name": "JULIANA",
        "middle_name": "MOBISOLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-18",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2317197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyde Park, MA

Sources for this page

Verify at the official NPI Registry.