Abimbola Otufale, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ01068500 Issued in NJ

Practice address

PO Box 748465
Atlanta, GA 30374-8465

Phone

(855) 284-7483

NPI assigned

Oct 13, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, NJ, CO, TX4 enrollments

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 4

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Moonshot Psychiatric Nurse Practitioner PCGroup PAC ID 9335589696, 79 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

State licenses

Practice roles (10 of 14)

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• Everpath Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Hackensack, NJ
  • NPI 1649072398

  NJ, Psychiatric/Mental Health, TX

  Medicare reassignment NPD Authorized official
• Moonshot Psychiatric Nurse Practitioner PC

  • Psychiatric/Mental Health Nurse Practitioner
  • Seattle, WA
  • NPI 1669158879

  Family, NJ

  Medicare reassignment Care Compare group NPD
• Thrive Counseling LLC

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300

  NJ

  Medicare reassignment Care Compare group NPD
• E & a Medical Solutions LLC

  • Multi-Specialty Clinic/Center
  • Bronx, NY
  • NPI 1730441791

  NY

  Medicare reassignment NPD
• Valera Medical, P.a.

  • Psychiatry Physician
  • Brooklyn, NY
  • NPI 1306435060

  NJ, Psychiatric/Mental Health

  Medicare reassignment NPD
• Valera Medical, P.a.

  • Psychiatry Physician
  • Brooklyn, NY
  • NPI 1871248757

  CO, Psychiatric/Mental Health

  Medicare reassignment NPD
• Valera Medical, P.C.

  • Psychiatry Physician
  • Brooklyn, NY
  • NPI 1437782349

  NY, Psychiatric/Mental Health

  Medicare reassignment NPD
• KS Medical, PC

  • Family Medicine Physician
  • Brooklyn, NY
  • NPI 1295131506

  NY

  Medicare reassignment
• Wellcare of BX Medical PC

  • Family Medicine Physician
  • Bronx, NY
  • NPI 1851848618

  NY

  Medicare reassignment
• Lavender New Jersey Psychiatric Nurse Practitioner PC

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
  • NPI 1629922950

  Family

  NPD
• Lifebulb LLC

  • Mental Health Counselor
  • Toms River, NJ
  • NPI 1699491464
  NPD (past)
• MBD Care LLC

  • Clinic/Center
  • Staten Island, NY
  • NPI 1538042650
  NPD (past)

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

{
    "created_epoch": "1602547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1508464397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252B CAMDEN ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 748465",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748465",
            "telephone_number": "855-284-7483"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "252B Camden St",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071032434",
            "country_code": "US",
            "telephone_number": "516-225-4296",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTUFALE",
        "first_name": "ABIMBOLA",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-13",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ01068500",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "346031",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "C-APN.0102715-C-NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "405429",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1161913",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karman Michelle Ott, APRN,BC
• Amy Ottensmeyer
• Stephanie Ottimo, NP
• Hunter Bryne Ottinger, PA-C
• Otto Bock Patient Care, LLC
• Roseline Otunga, FNP
• Jason Robert Otwell
• Spring Ou-Tim, CPNP
• Dave Wei-Huie Ou, MD
• Serge Ouanounou, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2025; 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.