Adebola Ajanaku
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Union, NJ
NPI 1669927224 · NPPES record last updated Aug 23, 2016
Key facts
- NPI
- 1669927224
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 26NJ00662000 (NJ)
- Practice address
- 1577 Ridgeway St
Union, NJ 07083-5129 - Phone
- (973) 342-5457
- NPI assigned
- Aug 23, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Landa Absolute Care LLC
Practice addresses (Care Compare)
50 Union Ave
Suite 701
Irvington, NJ 07111-3292
Phone (973) 849-6030
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170426002261 | NJ | Practitioner - Nurse Practitioner | 4587941760 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NJ00662000 | NJ | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| L&a Absolute Care LLC | Current |
Accepting new patients | |
| L&a Absolute Care LLC | Psychiatric/Mental Health | Current |
Accepting new patients |
| Barnabas Health Medical Group, PC | Current |
Accepting new patients |
Locations
50 Union Ave
Ste 701
Irvington, NJ 07111
Phone (973) 849-6030
201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455
223 Monmouth Rd
West Long Branch, NJ 07764
Phone (732) 229-3838
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 26NJ00662000 | NJ | Yes |
Addresses
Primary practice location
1577 Ridgeway St
Union, NJ 07083-5129
Mailing address
1577 Ridgeway St
Union, NJ 07083-5129
Phone (973) 342-5457
Other providers in Union, NJ
- Agape Christian Foundation Group
- Agcc Psychotherapy Services LLC
- Maryjo Agosta
- Jasleen Ahuja
- Lateef Ajanaku-Makun
- Shiyanbola Ajao
- Juliet Ajayi
- Modupeore Ajibade
- Ajt Behavioral Therapy Inc
- Nneka Gloria Akaeme
All providers in Union, NJ · Psychiatric/Mental Health Nurse Practitioner in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.