Mary Odusanya

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

26NJ00735000 Issued in NJ

Practice address

454 Morris Ave
Springfield, NJ 07081-1158

Phone

(908) 312-0288

Fax

(908) 484-9447

NPI assigned

Jun 20, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Atlantic Visiting Nurse Home health agency, Morristown, NJ, CCN 317054

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: maryodusanyanpn@montgomerymedical.medentdirect.com

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.

• Your Neighborhood Clinic LLC

  • Primary Care Clinic/Center
  • Springfield, NJ
  • NPI 1407424021
  Medicare reassignment NPD Authorized official
• Montgomery Medical Associates LLC

  • Internal Medicine Physician
  • Belle Mead, NJ
  • NPI 1366501462
  Medicare reassignment NPD
• New Jersey Post Acute Medical Services 1 PA

  • Hospitalist Physician
  • Red Bank, NJ
  • NPI 1578092391
  NPD (past)

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

• Ahs Hospital Corp.

  • Home Health Agency
  • Morristown, NJ
  • NPI 1962479667
  Care Compare affiliation

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1346770575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 MORRIS AVE",
            "city": "SPRINGFIELD",
            "state": "NJ",
            "postal_code": "070811158",
            "telephone_number": "908-312-0288",
            "fax_number": "908-484-9447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 MORRIS AVE",
            "city": "SPRINGFIELD",
            "state": "NJ",
            "postal_code": "070811158",
            "telephone_number": "908-312-0288",
            "fax_number": "908-484-9447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODUSANYA",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-20",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00735000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Helen L Nunez, MD
• Perpetual Nwolisa, PMHNP
• Alicia Ellen O'Connor, LCSW
• Ilyse O'Desky, PSY.D.
• Kelly O'Donnell, PA-C
• Funmilayo A Ogunruku, APN
• Ilanit Ohayon, SCHOOL PSYCHOLOGIST
• Ohi of Puerto Rico, LLC
• Ejiroghene Okopie
• Olga Byalik MD PC

• Family Nurse Practitioner in Springfield, NJ
• Providers in Springfield, NJ by specialty
• Family Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; 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.