Divine Oluwatosin Ojelade, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95029823 Issued in CA

Practice address

24060 Fir Ave Ste a
Moreno Valley, CA 92553-2895

Phone

(951) 247-8005

NPI assigned

May 1, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ademuyiwa Ojelade Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Heacock Health Medical Group, Inc.

  • Urgent Care Clinic/Center
  • Moreno Valley, CA
  • NPI 1891251849
  NPD (past)

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

{
    "created_epoch": "1714521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1417704032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16675 SHUNING CT",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925517491",
            "telephone_number": "310-909-4078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24060 FIR AVE STE A",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925532895",
            "telephone_number": "951-247-8005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16675 Shuning Ct",
            "address_purpose": "LOCATION",
            "city": "Moreno Valley",
            "state": "CA",
            "postal_code": "925517491",
            "country_code": "US",
            "telephone_number": "310-909-4078",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3300 N San Fernando Blvd # 201",
            "address_purpose": "LOCATION",
            "city": "Burbank",
            "state": "CA",
            "postal_code": "915042530",
            "country_code": "US",
            "telephone_number": "310-909-4078",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5015 Eagle Rock Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900412087",
            "country_code": "US",
            "telephone_number": "310-909-4078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OJELADE",
        "first_name": "DIVINE",
        "middle_name": "OLUWATOSIN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-01",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95029823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADEMUYIWA",
            "last_name": "OJELADE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jillian Mika Ogata
• Andrew Oh, DC
• Maxwell Ohikhuare, M.D.
• Ohs Medical Center
• Cesar Noe Ojeda Jr.
• Tessy Okafor
• Chitoo I Okonkwo, B.PHARM
• Blessing A. Okoro Rellias, PH.D.
• Olabode Olayinka Olatunji, PHARM. D
• Crystal Olea

• Family Nurse Practitioner in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.