Active NPI
Patrick Akinwumi Olowoporoku, APN, PMHNP-BC
- Psychiatric/Mental Health Nurse Practitioner
- Union, NJ
National Provider Identifier
1619740677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 26NJ14949800
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250324003404 | NJ | Practitioner - Nurse Practitioner | 4082137674 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NJ14949800 | NJ | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hopepath Healthcare Services LLC | Psychiatric/Mental Health | Current | Accepting new patients |
| Grace Medical Consult | Psychiatric/Mental Health | Past | Accepting new patients |
| L&a Absolute Care LLC | Psychiatric/Mental Health | Past | 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.
-
- Psychiatric/Mental Health Nurse Practitioner
- Union, NJ
- NPI 1477374460
-
- Psychiatric/Mental Health Nurse Practitioner
- Irvington, NJ
- NPI 1104370915
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.