Individual provider Active NPI

Wemimo Feyisayo Olagbaju, NP

  • Family Nurse Practitioner
  • West Covina, CA
National Provider Identifier
1164743233
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN965471 Issued in DC
Practice address
301 N Azusa Ave
West Covina, CA 91791-1346
Phone
(562) 359-6782
NPI assigned
Jun 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN965471 DC Primary
Family Nurse Practitioner 363LF0000X R141437 MD

Addresses

Primary practice location

301 N Azusa Ave
West Covina, CA 91791-1346

Mailing address

3601 Odonnell St
Baltimore, MD 21224-5238

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240515002215 CA Practitioner - Nurse Practitioner 5294994059 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN965471DCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Albion Medical Partners of California West P C CurrentSince Mar 2, 2024 Accepting new patients

Locations

12900 Park Plaza Dr
Ste 700
Cerritos, CA 90703
Phone (562) 622-2800

12900 Park Plaza Dr
Ste 150
Cerritos, CA 90703
Phone (562) 622-2800

Interoperability endpoints

  • Direct secure messaging: wemimo.olagbaju.p1@direct.caremorewest.nextgenshare.com
  • Direct secure messaging: wemimo.olagbaju.1@32527.direct.athenahealth.com

Organizations & group practices 1

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": "1276214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1164743233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 ODONNELL ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212245238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N AZUSA AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917911346",
            "telephone_number": "562-359-6782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLAGBAJU",
        "first_name": "WEMIMO",
        "middle_name": "FEYISAYO",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-11",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DC",
            "license": "RN965471",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R141437",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.