Individual provider Active NPI

Patrick Akinwumi Olowoporoku, APN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Union, NJ
National Provider Identifier
1619740677
Registry record updated Dec 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ14949800 Issued in NJ
Practice address
934 Stuyvesant Ave Ste 12a
Union, NJ 07083-6935
Phone
(917) 873-2593
Fax
(848) 900-8008
NPI assigned
Nov 1, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2025

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 26NJ14949800 NJ Primary

Addresses

Primary practice location

934 Stuyvesant Ave Ste 12a
Union, NJ 07083-6935

Mailing address

934 Stuyvesant Ave Ste 12a
Union, NJ 07083-6935
Phone (917) 873-2593

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
I20250324003404 NJ Practitioner - Nurse Practitioner 4082137674

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ14949800NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hopepath Healthcare Services LLC Psychiatric/Mental Health CurrentSince Mar 20, 2025 Accepting new patients
Grace Medical Consult Psychiatric/Mental Health PastSince Nov 1, 2023 Accepting new patients
L&a Absolute Care LLC Psychiatric/Mental Health PastSince Nov 1, 2023 Accepting new patients

Locations

934 Stuyvesant Ave
Ste 12A
Union, NJ 07083
Phone (848) 235-5934

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": "1698796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766275200000",
    "number": "1619740677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "934 STUYVESANT AVE STE 12A",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070836935",
            "telephone_number": "917-873-2593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "934 STUYVESANT AVE STE 12A",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070836935",
            "telephone_number": "917-873-2593",
            "fax_number": "848-900-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLOWOPOROKU",
        "first_name": "PATRICK",
        "middle_name": "AKINWUMI",
        "name_prefix": "Mr.",
        "credential": "APN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-01",
        "last_updated": "2025-12-21",
        "certification_date": "2025-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ14949800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, NJ

Sources for this page

Verify at the official NPI Registry.