Titilope Olaoluwa Omisakin, DNP, APRN, CNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

10421 Issued in MN

Practice address

9655 Schmidt Lake Rd Ste 150
Plymouth, MN 55442-4507

Phone

(763) 559-1640

NPI assigned

Jul 24, 2023

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 MN

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Plymouth Psych Group LLCGroup PAC ID 6800103490, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Plymouth Psych Group, LLC

  • Mental Health Counselor
  • Plymouth, MN
  • NPI 1003195942
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1690156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1407536345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1528 111TH DR NE UNIT D",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554494887",
            "telephone_number": "908-374-8661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9655 SCHMIDT LAKE RD STE 150",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554424507",
            "telephone_number": "763-559-1640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMISAKIN",
        "first_name": "TITILOPE",
        "middle_name": "OLAOLUWA",
        "name_prefix": "Dr.",
        "credential": "DNP, APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-24",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "10421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ibrahim Abdullahi Omar, MD
• Omega Health Supply & Delivery, Inc
• Ometta Health Care Services, Inc (Ometta Health Care)
• Ometta Vent Care Services, Inc (Ometta Vent Care)
• Ometta, LLC
• On-Belay of MN Incorporated (Anthony Louis Center)
• Steve Ongera-Ogega, ATC
• Opportunity Partners Inc. (Lavine Place)
• Optage Inc (Presbyterian Homes and Services Rehabilitation)
• Optima Care, LLC (Optima Home Care, LLC)

• Psychiatric/Mental Health Nurse Practitioner in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; 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.