Fadekemi Suliat Olude, APRN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1023087 Issued in TX

Practice address

444 E Boston Post Rd
Mamaroneck, NY 10543-3708

Phone

(713) 291-8625

NPI assigned

Dec 30, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, TX, CO, NM, OR, MN6 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 6

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Valera Medical PCGroup PAC ID 0547690521, 160 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Valera Medical, P.C.

  • Psychiatry Physician
  • Brooklyn, NY
  • NPI 1437782349

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Fo Nurse Practitioner in Psychiatry PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Rosedale, NY
  • NPI 1801627476
  Medicare reassignment Authorized official
• Goodness Psychiatry LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Dallas, TX
  • NPI 1346903754
  Medicare reassignment Authorized official
• Valera Medical, P.a.

  • Psychiatry Physician
  • Brooklyn, NY
  • NPI 1871248757

  CO, Single Specialty, TX

  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  CO, MN, NM, NY, OR, Single Specialty, TX

  Medicare reassignment NPD
• Phyllis Mandel MD PLLC

  • Internal Medicine Physician
  • New Rochelle, NY
  • NPI 1093977951

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1609286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1639766199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3449 AVA DR",
            "city": "MIDLOTHIAN",
            "state": "TX",
            "postal_code": "760652274",
            "telephone_number": "713-291-8625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 E BOSTON POST RD",
            "city": "MAMARONECK",
            "state": "NY",
            "postal_code": "105433708",
            "telephone_number": "713-291-8625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLUDE",
        "first_name": "FADEKEMI",
        "middle_name": "SULIAT",
        "credential": "APRN, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-30",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1023087",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "C-APN.0003755-C-NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "403381",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard C Ochei
• Marc Brian Ochs, LMT
• Michael Allen Oil, DDS
• Emperatriz Ojeda
• Sandra Oliva -Jovanovic, BCBA
• One Endo Support Services
• Open Door Family Medical Center, Inc.
• Optometry Eyecare on the Avenue PLLC
• Rosario Ortega, TEACHER
• Venus D. Osorio, MSW

• Psychiatric/Mental Health Nurse Practitioner in Mamaroneck, NY
• Providers in Mamaroneck, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; 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.