Individual provider Active NPI

Ayodola O Jatto, CRNP

  • Primary Care Nurse Practitioner
  • Hyattsville, MD
National Provider Identifier
1669054607
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
R129336 Issued in MD
Practice address
4118 70TH Ave
Hyattsville, MD 20784-2649
Phone
(240) 713-4166
NPI assigned
Apr 27, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X R129336 MD Primary

Addresses

Primary practice location

4118 70TH Ave
Hyattsville, MD 20784-2649

Mailing address

4118 70TH Ave
Hyattsville, MD 20784-2649
Phone (240) 713-4166

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20230327002440 MD Practitioner - Nurse Practitioner 3870994189 Reassigns benefits to 2 organizations
I20230327002610 DC Practitioner - Nurse Practitioner 3870994189 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
PA Post Acute Services PC CurrentSince Jan 31, 2024 Accepting new patients

Locations

2525 W Belvedere Ave
Baltimore, MD 21215
Phone (410) 367-9100

100 Laurel Dr
Elkton, MD 21921
Phone (410) 398-8800

3000 McComas Ave
Kensington, MD 20895
Phone (301) 491-3090

105 Time Sq
Salisbury, MD 21801
Phone (410) 749-2474

2601 Bel Pre Rd
Silver Spring, MD 20906
Phone (301) 598-6000

1234 Washington Rd
Westminster, MD 21157
Phone (410) 848-0700

10123 Alliance Rd
Ste 617
Blue Ash, OH 45242

6700 Columbia Pike
Annandale, VA 22003
Phone (703) 256-7000

Organizations & group practices 2

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": "1619481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1669054607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4118 70TH AVE",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207842649",
            "telephone_number": "240-713-4166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4118 70TH AVE",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207842649",
            "telephone_number": "240-713-4166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JATTO",
        "first_name": "AYODOLA",
        "middle_name": "O",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-27",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MD",
            "license": "R129336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyattsville, MD

Sources for this page

Verify at the official NPI Registry.