Active NPI
Olusegun Olaosebikan, DNP, MS, MPH, APRN-C
- Adult Health Nurse Practitioner
- Windsor, CT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 8056
- Practice address
- 1 Emerson Dr
Windsor, CT 06095-3204 - Phone
- (860) 688-6443
- NPI assigned
- Jan 14, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 8056 | CT | |
| Adult Health Nurse Practitioner | 363LA2200X | 8056 | CT | Primary |
Addresses
Primary practice location
1 Emerson Dr
Windsor, CT 06095-3204
Mailing address
PO Box 2491
Vernon Rockville, CT 06066-8591
Phone (316) 204-0504
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
101 Centerpoint Dr
Suite 215
Middletown, CT 06457-7568
Phone (888) 964-6681
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8056 | CT | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alignmed Partners, PC | Current | Accepting new patients | |
| Careconnectmd Connecticut PC | Current | Accepting new patients | |
| Value Based Long Term Care H PC | Current | Accepting new patients | |
| Healthdrive Medical Services Southeast LLC | Nurse Practitioner | Current | Accepting new patients |
| HDC Care Solutions, LLC | Nurse Practitioner | Current | Accepting new patients |
| Absolute Outcomes, LLC | Past | Accepting new patients |
Locations
3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182
850 Mix Ave
Hamden, CT 06514
Phone (203) 281-3500
101 Centerpoint Dr
Ste 215
Middletown, CT 06457
Phone (203) 696-3550
5 Research Dr
Shelton, CT 06484
Phone (203) 567-5264
1266 E Main St
Stamford, CT 06902
Phone (203) 276-3000
1 Emily Way
West Hartfrd, CT 06107
Phone (860) 561-7022
1 Emerson Dr
Windsor, CT 06095
Phone (860) 688-6443
Organizations & group practices 6
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705968000000",
"number": "1669946588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2491",
"city": "VERNON ROCKVILLE",
"state": "CT",
"postal_code": "060668591",
"telephone_number": "316-204-0504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 EMERSON DR",
"city": "WINDSOR",
"state": "CT",
"postal_code": "060953204",
"telephone_number": "860-688-6443"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLAOSEBIKAN",
"first_name": "OLUSEGUN",
"credential": "DNP, MS, MPH, APRN-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-01-14",
"last_updated": "2024-01-23",
"certification_date": "2024-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CT",
"license": "8056",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "CT",
"license": "8056",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Windsor, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.