Individual provider Active NPI

Folukemi Bosede Fakinlede

  • Psychiatric/Mental Health Nurse Practitioner
  • Princeton, NJ
National Provider Identifier
1508677089
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ15237400 Issued in NJ
Practice address
132 Main St
Princeton, NJ 08540-5733
Phone
(732) 589-8733
NPI assigned
Jan 15, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

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 26NJ15237400 NJ Primary

Addresses

Primary practice location

132 Main St
Princeton, NJ 08540-5733

Mailing address

132 Main St
Princeton, NJ 08540-5733
Phone (609) 336-5352

Other practice location 1

550 Broad St Ste 606
Newark, NJ 07102-4537
Phone (201) 822-1161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20250522002405 NJ Practitioner - Nurse Practitioner 8022537067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
JLS Medical PCGroup PAC ID 7719342005, 53 clinicians

Practice addresses (Care Compare)

3 Garret Mountain PLZ
Suite 200
Woodland Park, NJ 07424-3376
Phone (201) 822-1161

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
JLS Medical PC Psychiatric/Mental Health CurrentSince May 19, 2025 Accepting new patients
Hoperestoredmd LLC CurrentSince Aug 17, 2025 Accepting new patients
Bancroft, a New Jersey Nonprofit Corporation PastSince May 19, 2025 Accepting new patients

Locations

550 Broad St
Ste 606
Newark, NJ 07102
Phone (425) 458-8525

132 Main St
Princeton, NJ 08540
Phone (609) 336-5352

3 Garret Mountain Plz
Ste 200
Woodland Park, NJ 07424

Organizations & group practices 3

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": "1736899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1508677089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 MAIN ST",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085405733",
            "telephone_number": "609-336-5352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 MAIN ST",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085405733",
            "telephone_number": "732-589-8733"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 Broad St Ste 606",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071024537",
            "country_code": "US",
            "telephone_number": "201-822-1161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAKINLEDE",
        "first_name": "FOLUKEMI",
        "middle_name": "BOSEDE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-15",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ15237400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

Verify at the official NPI Registry.