Keyamo M Omokuru, DNP, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP141260 Issued in TX

Practice address

928 W Commerce St
San Antonio, TX 78207-4444

Phone

(210) 261-1250

Fax

(210) 434-0716

NPI assigned

Jan 25, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Bexar County Board of Trustees for Mental Health Mental RetardationGroup PAC ID 5496652760, 59 clinicians

Mypsych Mental Health, PLLCGroup PAC ID 5890078042, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Bexar County Board of Trustees for Mental Health Mental Retardation

  • Counselor
  • San Antonio, TX
  • NPI 1730134586
  Medicare reassignment Care Compare group NPD
• Mypsych Mental Health, PLLC

  • Psychiatry Physician
  • San Antonio, TX
  • NPI 1871962191
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1264377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556755200000",
    "number": "1295066694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 PARK TEN BLVD STE 200S",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782134293",
            "telephone_number": "210-261-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 W COMMERCE ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782074444",
            "telephone_number": "210-261-1250",
            "fax_number": "210-434-0716"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7563 Black Squirrel Trl",
            "address_purpose": "LOCATION",
            "city": "Hamilton",
            "state": "OH",
            "postal_code": "450117613",
            "country_code": "US",
            "telephone_number": "513-807-7507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OMOKURU",
        "first_name": "KEYAMO",
        "middle_name": "M",
        "credential": "DNP, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-25",
        "last_updated": "2019-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN 19805",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP141260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Omnicure Plus Home Healthcare LLC
• Omniphasic Institute
• Omo Cares, LLC
• Yimi Omofuma, M.A, PHD
• Precious Omokaro
• Oluwatosin Omole, M.D, MPH
• Dorothy Nabwire Omondi, RN
• Osabuohien Omoregie, DNP
• Abiodun Omotoyo
• Jadesola I Omoyeni, M.D

• Psychiatric/Mental Health Nurse Practitioner in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2019; 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.