Individual provider Active NPI

Mosunmola Ogunyinmi, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Bellevue, WA
National Provider Identifier
1205495165
Registry record updated Apr 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
247940 Issued in AZ
Practice address
4122 Factoria Blvd SE Ste 305
Bellevue, WA 98006-5259
Phone
(832) 340-8362
NPI assigned
Jun 13, 2019
Last updated
Apr 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP141774 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 247940 AZ Primary
Occupational Health Nurse Practitioner 363LX0106X AP61239561 WA

Addresses

Primary practice location

4122 Factoria Blvd SE Ste 305
Bellevue, WA 98006-5259

Mailing address

4122 Factoria Blvd SE Ste 305
Bellevue, WA 98006-5259
Phone (832) 340-8362

Other practice location 1

16211 Clay Rd Ste 110
Houston, TX 77084-5420
Phone (832) 340-8362

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX, WA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20210712003661 AZ Practitioner - Nurse Practitioner 3375945454 Reassigns benefits to 2 organizations
I20240222003492 TX Practitioner - Nurse Practitioner 3375945454 Reassigns benefits to 5 organizations
Practice locations: Houston, TX
I20240902000373 WA Practitioner - Nurse Practitioner 3375945454 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jason D. Baron, M.D., PAGroup PAC ID 5597750885, 7 clinicians

Practice addresses (Care Compare)

5500 Guhn Rd
Suite 100
Houston, TX 77040-6162
Phone (713) 783-8889

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP141774TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Intervention Assciates, Inc CurrentSince Jun 7, 2021 Accepting new patients
Pinal Hispanic Council Current Accepting new patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Jul 19, 2024 Accepting new patients
Community Intervention Associates, Inc. CurrentSince Jun 7, 2021 Accepting new patients
Community Intervention Associates, Inc. Current Accepting new patients
Community Partners Integrated Healthcare, Inc. Current Accepting new patients
Sondermind Provider Network LLC Psychiatric/Mental Health CurrentSince Sep 1, 2025 Accepting new patients
Mental Health Specialty Group PA CurrentSince May 2, 2025 Accepting new patients
Behavioral Consultation Services, Inc. Past Accepting new patients

Locations

1326 W Highway 92
Ste J
Bisbee, AZ 85603
Phone (520) 366-3603

107 E 4th St
Eloy, AZ 85131
Phone (480) 247-7619

275 W Continental Rd
Green Valley, AZ 85622
Phone (520) 625-4401

32 Boulevard del Rey David
Nogales, AZ 85621
Phone (520) 281-9189

1516 S Ocotillo Ave
Parker, AZ 85344
Phone (928) 669-5319

1515 E Osborn Rd
Phoenix, AZ 85014
Phone (602) 604-0000

4600 E Washington St
Ste 300
Phoenix, AZ 85034
Phone (602) 638-1872

301 E 4th St
Ste A
Safford, AZ 85546
Phone (928) 792-4242

1773 W Saint Marys Rd
Ste 102
Tucson, AZ 85745
Phone (520) 622-8357

5055 E Broadway Blvd
Ste A200
Tucson, AZ 85711
Phone (520) 901-4701

2545 S Arizona Ave
Bldg A
Yuma, AZ 85364

2851 S Avenue B
Bldg 4
Yuma, AZ 85364
Phone (928) 919-2436

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

2021 Guadalupe St
Ste 260
Austin, TX 78705
Phone (202) 932-9958

600 Congress Ave
Austin, TX 78701
Phone (281) 330-3059

700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391

1455 NW Leary Way
Ste 400
Seattle, WA 98107
Phone (206) 202-8506

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743724800000",
    "number": "1205495165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4122 FACTORIA BLVD SE STE 305",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980065259",
            "telephone_number": "832-340-8362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4122 FACTORIA BLVD SE STE 305",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980065259",
            "telephone_number": "832-340-8362"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16211 Clay Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770845420",
            "country_code": "US",
            "telephone_number": "832-340-8362",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OGUNYINMI",
        "first_name": "MOSUNMOLA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-13",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP141774",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "247940",
            "primary": true
        },
        {
            "code": "363LX0106X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Occupational Health",
            "state": "WA",
            "license": "AP61239561",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.