Individual provider Active NPI

Olawande Harry Awopetu

  • Psychiatric/Mental Health Nurse Practitioner
  • New Rochelle, NY
National Provider Identifier
1487328605
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F403418-01 Issued in NY
Practice address
15 Davenport Ave Apt 3F
New Rochelle, NY 10805-3430
Phone
(646) 648-8406
NPI assigned
Aug 2, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F403418-01 NY Primary

Addresses

Primary practice location

15 Davenport Ave Apt 3F
New Rochelle, NY 10805-3430

Mailing address

15 Davenport Ave Apt 3F
New Rochelle, NY 10805-3430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20220822000191 NY Practitioner - Nurse Practitioner 7810376035 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Mental Health Association of Westchester County IncGroup PAC ID 0244121366, 24 clinicians

Practice addresses (Care Compare)

20 S Broadway
Suite 402
Yonkers, NY 10701-3723
Phone (914) 345-5900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F403418-01NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Oct 18, 2024 Accepting new patients
The Guidance Center of Westchester, Inc CurrentSince Jun 2, 2025 Accepting new patients
The Mental Health Association of Westchester County - Social Care Network Past Accepting new patients
Puerto Rican Organization to Motivate Enlighten and Serve Addicts Inc Past Accepting new patients

Locations

256 Washington St
Ste 2
Mount Vernon, NY 10553
Phone 91461307003338

20 Sickles Ave
New Rochelle, NY 10801
Phone (914) 632-1374

165 Broadway
Fl 23
New York, NY 10006
Phone (202) 972-4964

Organizations & group practices 5

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": "1627862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1487328605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 DAVENPORT AVE APT 3F",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108053430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 DAVENPORT AVE APT 3F",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108053430",
            "telephone_number": "646-648-8406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AWOPETU",
        "first_name": "OLAWANDE",
        "middle_name": "HARRY",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-02",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F403418-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Rochelle, NY

Sources for this page

Verify at the official NPI Registry.