Michael Olusegun Adeduro, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95023296 Issued in CA

Practice address

4653 Vahan CT
Lancaster, CA 93536-6880

Phone

(661) 916-5608

NPI assigned

Nov 14, 2022

Last updated

Nov 14, 2022By the provider in NPPES

Sex

Male

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 CA

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

County of KernGroup PAC ID 7810887205, 75 clinicians

Tarzana Treatment Centers IncGroup PAC ID 5991897845, 55 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9357/brand/1/csg/1/fhir/r4

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.

• County of Kern

  dba Kern BHRS Westchester

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bakersfield, CA
  • NPI 1568658821
  Medicare reassignment Care Compare group NPD
• Tarzana Treatment Centers, Inc.

  • Community/Behavioral Health Agency
  • Lancaster, CA
  • NPI 1346842093
  Medicare reassignment Care Compare group NPD
• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Mellow Medical Inc a Professional Corporation

  • Psychiatry Physician
  • West Hollywood, CA
  • NPI 1407275886
  Medicare reassignment NPD
• Sud Specialty Group - Ca

  dba Rula Health

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Santa Clara, CA
  • NPI 1972138238

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Michris LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Palmdale, CA
  • NPI 1295594976
  Authorized official Same address or phone
• County of Kern

  dba Kern BHRS Green Gardens

  • Adult Mental Health Clinic/Center
  • Bakersfield, CA
  • NPI 1467653253
  NPD
• Tarzana Treatment Centers, Inc.

  • Multi-Specialty Clinic/Center
  • Northridge, CA
  • NPI 1427043389
  NPD
• Tarzana Treatment Centers, Inc.

  • Multi-Specialty Clinic/Center
  • Palmdale, CA
  • NPI 1619702099
  NPD

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

{
    "created_epoch": "1668384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1386352789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4653 VAHAN CT",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935366880",
            "telephone_number": "661-916-5608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4653 VAHAN CT",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935366880",
            "telephone_number": "661-916-5608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEDURO",
        "first_name": "MICHAEL",
        "middle_name": "OLUSEGUN",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-14",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95023296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Michelle Adal
• Jennifer Adamo
• Cynthia J Adams, MFT
• Jacqueline Marcelaine Adams
• Karimat Adebiyi
• Omorogiuwa Adeneye, PMHNP
• Oluwadamilola Aderibigbe
• Ginalen Adeva
• Omude Adigheji, PMHNP
• Adjusted Situations for All

• Psychiatric/Mental Health Nurse Practitioner in Lancaster, CA
• Providers in Lancaster, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.