Individual provider Active NPI

Jenny O Olaleye, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1467039677
Registry record updated Oct 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1032627 Issued in TX
Practice address
221 W Colorado Blvd
Dallas, TX 75208-2363
Phone
(214) 946-9898
NPI assigned
Mar 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1032627 TX Primary

Addresses

Primary practice location

221 W Colorado Blvd
Dallas, TX 75208-2363

Mailing address

221 W Colorado Blvd
Pav II, Suite 933
Dallas, TX 75208
Phone (469) 879-8513

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL URL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20210804000179 TX Practitioner - Nurse Practitioner 2264836840 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heartful Cardiology, PLLCGroup PAC ID 0749694909, 3 clinicians

Practice addresses (Care Compare)

1400 Hwy 287 N
Suite 101
Mansfield, TX 76063-9210
Phone (817) 752-5242

Hospital & facility affiliations

  • Methodist Mansfield Medical Center Hospital, Mansfield, TX, CCN 670023

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1032627TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
G. Mark Jenkins, MD PA CurrentSince Apr 24, 2021 Accepting new patients
Heartful Cardiology, PLLC CurrentSince Dec 19, 2023 Accepting new patients

Locations

221 W Colorado Blvd
Ste 933
Dallas, TX 75208
Phone (214) 941-7200

1400 Highway 287 N
Ste 101
Mansfield, TX 76063
Phone (817) 752-5242

1400 Highway 287 N
Ste 100
Mansfield, TX 76063
Phone (817) 752-5242

2800 E Broad St
Ste 204
Mansfield, TX 76063
Phone (682) 900-4174

Interoperability endpoints

  • Direct secure messaging: olaleye_jenny@7f324e07.micromddirect.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1467039677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 W COLORADO BLVD",
            "address_2": "PAV II, SUITE 933",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75208",
            "telephone_number": "469-879-8513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W COLORADO BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752082363",
            "telephone_number": "214-946-9898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLALEYE",
        "first_name": "JENNY",
        "middle_name": "O",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-24",
        "last_updated": "2021-10-04",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1032627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "URL",
            "affiliation": "N",
            "address_1": "221 W Colorado Blvd",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752082363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.