Olatunji Ismail Iberu-Olushoga, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R214785 Issued in MD

Practice address

1509 Fitzpatrick Dr
Severn, MD 21144-3142

Phone

(130) 172-8034

NPI assigned

Jul 4, 2021

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MD

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

Merit-based Incentive Payment System (MIPS)

Final score

17.27 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

57.57

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Mercy Health Pathway LLC

  • Family Nurse Practitioner
  • Severn, MD
  • NPI 1942993019
  Medicare reassignment Authorized official
• Juniper Healthcare LLC

  • Nurse Practitioner
  • Catonsville, MD
  • NPI 1346608171
  Medicare reassignment NPD

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

{
    "created_epoch": "1625356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625356800000",
    "number": "1104497841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 FITZPATRICK DR",
            "city": "SEVERN",
            "state": "MD",
            "postal_code": "211443142",
            "telephone_number": "130-172-8034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 FITZPATRICK DR",
            "city": "SEVERN",
            "state": "MD",
            "postal_code": "211443142",
            "telephone_number": "130-172-8034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBERU-OLUSHOGA",
        "first_name": "OLATUNJI",
        "middle_name": "ISMAIL",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-04",
        "last_updated": "2021-07-04",
        "certification_date": "2021-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R214785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "iberu-olushogao@futurecare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1509 Fitzpatrick Dr",
            "city": "Severn",
            "state": "MD",
            "country_code": "US",
            "postal_code": "211443142",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "iberu-olushogao@futurecare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1509 Fitzpatrick Dr",
            "city": "Severn",
            "state": "MD",
            "country_code": "US",
            "postal_code": "211443142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hope Mental Health & Family Healthcare Services , LLC
• Kimberly H Housman, RN
• Anthony Hughley, RN
• Kim Hunter Nichols, OTR/L
• Sayyed Adil Hussain, FNP-C
• Sylvia Ibetoh
• Linda Nwanyieze Idowu, LMSW
• Integrative Healing Journeys
• Laura Jeanne Ironman, M.S., CF-SLP
• Ruqayyah Jalloh, LGSW

• Family Nurse Practitioner in Severn, MD
• Providers in Severn, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2021; 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.