Bola D Osunkiyesi

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R190321 Issued in MD

Practice address

6239 Seton Hills LN
Gwynn Oak, MD 21207-6098

Phone

(443) 469-9528

NPI assigned

Nov 20, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MD

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• True Vine Health Systems Inc.

  • Psychiatric/Mental Health Nurse Practitioner
  • Gwynn Oak, MD
  • NPI 1831830231
  Medicare reassignment NPD Authorized official
• Salus Health Inc

  • Nurse Practitioner
  • Baltimore, MD
  • NPI 1285244004
  Medicare reassignment NPD

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621036800000",
    "number": "1427651561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6239 SETON HILLS LN",
            "city": "GWYNN OAK",
            "state": "MD",
            "postal_code": "212076098",
            "telephone_number": "443-469-9528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6239 SETON HILLS LN",
            "city": "GWYNN OAK",
            "state": "MD",
            "postal_code": "212076098",
            "telephone_number": "443-469-9528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSUNKIYESI",
        "first_name": "BOLA",
        "middle_name": "D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-20",
        "last_updated": "2021-05-15",
        "certification_date": "2021-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R190321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "SOAP",
            "affiliation": "N",
            "address_1": "Spring Grove Hospital Center",
            "address_2": "55 Wade Avenue",
            "city": "Catonsville",
            "state": "MD",
            "country_code": "US",
            "postal_code": "21228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christian Oglesby
• Damilola Bolanle Ogunyanwo, NP
• Olubunmi Oyebanke Okuwa, SOCIAL WORKER
• Efetobore Omadevuae
• Optimum Medical Group Inc.
• Eniola Joy Osunnuga, WHNP-BC
• Carmen Pendleton, LCPC
• Alyzza Anne Peters, BT
• Shanay T Plater, RN
• Shaterra S Plummer, DNP, FNP-C

• Psychiatric/Mental Health Nurse Practitioner in Gwynn Oak, MD
• Providers in Gwynn Oak, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2021; 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.