Ololade Ikuomola, NP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

R201929 Issued in MD

Practice address

1124 Mace Ave
Baltimore, MD 21221-3315

Phone

(410) 391-6996

Fax

(410) 687-6877

NPI assigned

Jun 19, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mace Medical LLCGroup PAC ID 8123308020, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JHCFBA

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.

• Mace Medical LLC

  • Internal Medicine Physician
  • Essex, MD
  • NPI 1114374360
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1497830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1114457421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 MACE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212213315",
            "telephone_number": "410-391-6996",
            "fax_number": "410-687-6877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 MACE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212213315",
            "telephone_number": "410-391-6996",
            "fax_number": "410-687-6877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKUOMOLA",
        "first_name": "OLOLADE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MD",
            "license": "R201929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Moses Ekemezie Ikejiofor, PMHNP
• Aruna Ikharia
• Eseigboria J Ikheloa, MD
• Stella Ikpe, FNP
• Prosper Ikenna Ikpeama
• Stephanie Ikwueme
• Yvette Ilechie
• Bogdan Manuel Iliescu, M.D.
• Nicholas Iliff, M.D.
• Peter Illei, M.D.

• Primary Care Nurse Practitioner in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Primary Care Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.