Individual provider Active NPI

Olayinka Oyawusi, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
National Provider Identifier
1215660337
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
202213788NP-PP Issued in OR
Practice address
2175 NW Raleigh St Ste 110
Portland, OR 97210-2392
Phone
(800) 465-3203
NPI assigned
Jul 6, 2022
Last updated
Nov 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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 Nurse Practitioner 363LP0808X 202213788NP-PP OR Primary

Addresses

Primary practice location

2175 NW Raleigh St Ste 110
Portland, OR 97210-2392

Mailing address

2386 Morris Ave Ste 107-109
Union, NJ 07083-5723

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20240823000099 NY Practitioner - Nurse Practitioner 2860931771 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TBHC Physician Services PCGroup PAC ID 9133265317, 111 clinicians

Practice addresses (Care Compare)

121 Dekalb Ave
Brooklyn, NY 11201-5425
Phone (718) 250-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
202213788NP-PPORMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Medical Center CurrentSince Mar 9, 2025 Accepting new patients
Emet Integrative Psychiatry Psychiatric/Mental Health Current Accepting new patients
Clear Thoughts Healthcare LLC Multi-Specialty CurrentSince Jul 1, 2022 Accepting new patients
TBHC Physician Services PC Multi-Specialty CurrentSince Jul 1, 2024 Accepting new patients
Samaritan Medical Center Multi-Specialty Current Accepting new patients
Samaritan Medical Center CurrentSince Mar 9, 2025 Accepting new patients
Cornerstone NP in Psychiatry, PLLC Multi-Specialty CurrentSince Nov 1, 2024 Accepting new patients
Amity Healthcare Services Multi-Specialty PastSince Jul 1, 2022 Accepting new patients

Locations

2386 Morris Ave
Ste 107109
Union, NJ 07083
Phone (718) 314-6350

10881 US Route 11
Adams, NY 13605
Phone (315) 232-4400

121 DeKalb Ave
Brooklyn, NY 11201
Phone (718) 250-6604

1441 Broadway
Ste 6026
New York, NY 10018
Phone (718) 200-5446

1575 Washington St
Watertown, NY 13601
Phone (315) 779-5060

830 Washington St
Watertown, NY 13601
Phone (315) 785-4000

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: ooyawusi21924@prd.direct.tbh.org

Organizations & group practices 8

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1657065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1215660337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2386 MORRIS AVE STE 107-109",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070835723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2175 NW RALEIGH ST STE 110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102392",
            "telephone_number": "800-465-3203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OYAWUSI",
        "first_name": "OLAYINKA",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-06",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "202213788NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.