Individual provider Active NPI

Margaret Olusesan Omojola, A.P.R.N.

  • Family Nurse Practitioner
  • Waterbury, CT
National Provider Identifier
1285070854
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
005219 Issued in CT
Practice address
50 Brookside Rd
Waterbury, CT 06708-1402
Phone
(203) 568-7474
Fax
(203) 568-7474
NPI assigned
May 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 005219 CT Primary

Addresses

Primary practice location

50 Brookside Rd
Waterbury, CT 06708-1402

Mailing address

263 Farmington Ave
Farmington, CT 06030-0001
Phone (860) 679-4477

Other identifiers 1

IdentifierTypeStateIssuer
1285070854MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, MA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20140109000112 CT Practitioner - Nurse Practitioner 7517195076 Reassigns benefits to 6 organizations
I20200407003070 MA Practitioner - Nurse Practitioner 7517195076 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005219CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ma Pacs 2 PC CurrentSince Sep 30, 2020 Accepting new patients
Prohealth Physicians PC Family CurrentSince Jul 10, 2017 Accepting new patients
Ipc Hospitalists of New England PC CurrentSince Feb 9, 2015 Accepting new patients
CS Pacs 3 Northeast, LLC CurrentSince Aug 1, 2024 Accepting new patients
Alignmed Partners, PC CurrentSince Jan 1, 2018 Accepting new patients
Ilera Medical LLC Family Current Accepting new patients
Connecticut Post Acute Medical Services 1 PC CurrentSince Sep 1, 2017 Accepting new patients
Ipc Hospitalists of New England, P.C. Family Current Accepting new patients
Ipc Hospitalists of New England, P.C. Family CurrentSince Mar 1, 2020 Accepting new patients
Ipc Hospitalists of New England, P.C. Family CurrentSince Feb 9, 2015 Accepting new patients
University of Connecticut Health Center Past Accepting new patients

Locations

263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477

850 Mix Ave
Hamden, CT 06514
Phone (203) 281-3500

111 Church St
Middletown, CT 06457
Phone (860) 347-3786

31 Vauxhall St
New London, CT 06320
Phone (203) 789-1650

365 Montauk Ave
New London, CT 06320
Phone (860) 271-4364

88 Clark Ln
Waterford, CT 06385
Phone (860) 442-0471

1 Emerson Dr
Windsor, CT 06095
Phone (860) 688-6443

115 Spencer St
Winsted, CT 06098
Phone (860) 738-5810

5870 N Hiatus Rd
Tamarac, FL 33321
Phone (957) 377-2954

67 Union St
Natick, MA 01760
Phone (508) 383-1104

Interoperability endpoints

  • Direct secure messaging: momojola@landmarkhealth-direct.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1369180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777593600000",
    "number": "1285070854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060300001",
            "telephone_number": "860-679-4477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 BROOKSIDE RD",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067081402",
            "telephone_number": "203-568-7474",
            "fax_number": "203-568-7474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMOJOLA",
        "first_name": "MARGARET",
        "middle_name": "OLUSESAN",
        "credential": "A.P.R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-22",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "005219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285070854",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.