Individual provider Active NPI

Adetutu Olufunmilayo Marioghae

  • Women's Health Nurse Practitioner
  • Arlington, VA
National Provider Identifier
1326500976
Registry record updated Jan 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
0024176630 Issued in VA
Practice address
1101 Wilson Blvd FL 6
Arlington, VA 22209-2281
Phone
(888) 731-8994
NPI assigned
Apr 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 0024176630 VA Primary

Addresses

Primary practice location

1101 Wilson Blvd FL 6
Arlington, VA 22209-2281

Mailing address

1101 Wilson Blvd FL 6
Arlington, VA 22209-2281
Phone (888) 731-8994

Other identifiers 1

IdentifierTypeStateIssuer
0024176630OtherVACOMMONWEALTH OF VIRGINIA DEPARTMENT OF HEALTH PROFESSION

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12783 Sidney Way
Lake Ridge, VA 22192-7611

4619 Sunflower CT
Woodbridge, VA 22192-6124

8201 Corporate Dr
Suite 630
Hyattsville, MD 20785-2258

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024176630VAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Serenity Women'S Healthcare LLC CurrentSince May 14, 2026 Accepting new patients

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": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768780800000",
    "number": "1326500976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 WILSON BLVD FL 6",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222092281",
            "telephone_number": "888-731-8994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 WILSON BLVD FL 6",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222092281",
            "telephone_number": "888-731-8994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIOGHAE",
        "first_name": "ADETUTU",
        "middle_name": "OLUFUNMILAYO",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-03",
        "last_updated": "2026-01-19",
        "certification_date": "2026-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "VA",
            "license": "0024176630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMONWEALTH OF VIRGINIA DEPARTMENT OF HEALTH PROFESSION",
            "identifier": "0024176630",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

Verify at the official NPI Registry.