Individual provider Active NPI

Oluwaseyi Banjo, NP

  • Family Nurse Practitioner
  • Alexandria, VA
National Provider Identifier
1356838536
Registry record updated Apr 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024175370 Issued in VA
Practice address
1636 Belle View Blvd
Alexandria, VA 22307-6531
Phone
(703) 768-7044
NPI assigned
Apr 13, 2018
Last updated
Apr 13, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2018

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 0024175370 VA Primary

Addresses

Primary practice location

1636 Belle View Blvd
Alexandria, VA 22307-6531

Mailing address

1636 Belle View Blvd
Alexandria, VA 22307-6531

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 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
I20180523002331 DC Practitioner - Nurse Practitioner 4587929450 Reassigns benefits to 2 organizations
I20180713001990 VA Practitioner - Nurse Practitioner 4587929450 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Diagnostic of Virginia LLCGroup PAC ID 6709960891, 142 clinicians

Practice addresses (Care Compare)

1636 Belle View Blvd
Alexandria, VA 22307-6531
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024175370VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Primary Care - Virginia PLLC Family CurrentSince Jul 16, 2025 Accepting new patients

Locations

1636 Belle View Blvd
Alexandria, VA 22307
Phone (703) 703-7687

7205 Little River Tpke
Annandale, VA 22003
Phone (703) 256-4030

10250 Bristow Center Dr
Bristow, VA 20136
Phone (703) 369-1739

19305 Ruby Dr
Leesburg, VA 20176
Phone (571) 333-5918

Networks

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

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1523577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523577600000",
    "number": "1356838536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1636 BELLE VIEW BLVD",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223076531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1636 BELLE VIEW BLVD",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223076531",
            "telephone_number": "703-768-7044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANJO",
        "first_name": "OLUWASEYI",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-13",
        "last_updated": "2018-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024175370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.