Individual provider Active NPI

Deborah F Olusanjo, APRN-CNP

  • Acute Care Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1407501695
Registry record updated Feb 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
206815 Issued in OK
Practice address
4050 W Memorial Rd FL 3
Oklahoma City, OK 73120-8382
Phone
(405) 608-3800
Fax
(405) 608-1594
NPI assigned
Feb 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 206815 OK
Gerontology Nurse Practitioner 363LG0600X 206815 OK
Acute Care Nurse Practitioner 363LA2100X 206815 OK Primary

Addresses

Primary practice location

4050 W Memorial Rd FL 3
Oklahoma City, OK 73120-8382

Mailing address

7800 NW 85TH Ter
Oklahoma City, OK 73132-3385

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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

Enrollment IDStateProvider typePAC IDDetails
I20220323001802 OK Practitioner - Nurse Practitioner 5294120564 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
77.26 of 100Reported as group
Quality
53.73
Promoting interoperability
100
Improvement activities
40
Cost
70.48

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
206815OKMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ou Health Partners, Inc CurrentSince Jul 6, 2022 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 6, 2022 Accepting new patients
Signify Health, LLC CurrentSince Dec 6, 2022 Accepting new patients

Locations

10601 S Western Ave
Ste 100
Oklahoma City, OK 73170

825 NE 10th St
Ste 2G
Oklahoma City, OK 73104
Phone (405) 271-4460

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 3

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": "1644969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1407501695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 NW 85TH TER",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731323385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 W MEMORIAL RD FL 3",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208382",
            "telephone_number": "405-608-3800",
            "fax_number": "405-608-1594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLUSANJO",
        "first_name": "DEBORAH",
        "middle_name": "F",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-16",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OK",
            "license": "206815",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OK",
            "license": "206815",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OK",
            "license": "206815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.