Abimbola Ololade Adeboye, MHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP143589 Issued in TX

Practice address

4645 Samuell Blvd
Dallas, TX 75228-6826

Phone

(214) 743-1200

NPI assigned

Oct 18, 2019

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX, FL2 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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Brave Health Medical Group, PA 93 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: abimbola.adeboye.1@23300.direct.athenahealth.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.

• Brave Health Medical Group PA

  • Community/Behavioral Health Agency
  • Miami, FL
  • NPI 1225669161

  TX

  Medicare reassignment Care Compare group NPD
• Dallas County Mental Health & Mental Retardation Center

  • Psychiatry Physician
  • Dallas, TX
  • NPI 1023239886

  TX

  Medicare reassignment NPD
• Author Health Professionals, PC

  • Psychiatry Physician
  • Miami, FL
  • NPI 1740897321

  FL, TX

  Medicare reassignment
• Dallas County Mental Health & Mental Retardation Center

  • Clinic Pharmacy
  • Grand Prairie, TX
  • NPI 1093114134
  NPD (past)

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

{
    "created_epoch": "1571356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1356984728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 ANN CT",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760638671",
            "telephone_number": "817-583-2765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4645 SAMUELL BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752286826",
            "telephone_number": "214-743-1200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1345 River Bend Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752476945",
            "country_code": "US",
            "telephone_number": "214-743-1200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4505 Ann Ct",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "TX",
            "postal_code": "760638671",
            "country_code": "US",
            "telephone_number": "817-583-2765",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1020 S Carrier Pkwy",
            "address_purpose": "LOCATION",
            "city": "Grand Prairie",
            "state": "TX",
            "postal_code": "750511527",
            "country_code": "US",
            "telephone_number": "214-330-2488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADEBOYE",
        "first_name": "ABIMBOLA",
        "middle_name": "OLOLADE",
        "name_prefix": "Mrs.",
        "credential": "MHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-18",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP143589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OF NURSING",
            "identifier": "AP143589",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "address_1": "4505 Ann Ct",
            "city": "Mansfield",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760638671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tayo A Addo, MD
• Adean Kingston MD PLLC
• Olasubomi O Adebanjo-Onapeju, LPC
• Elizabeth Adebayo, NP
• Olubukola Michelle Adebiyi, D.C
• Mudasiru A Adeboye, PHARM.D
• Emmanuel Adetunji Adebunmi, RPH
• Stella O Adebusoye, DNP,PMHNP,FNP,APRNBC
• Inioluwa Adedokun, RN
• Temitope O. Adedolapo

• All providers in Dallas, TX
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2022; 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.