Individual provider Active NPI

Olusegun Olaosebikan, DNP, MS, MPH, APRN-C

  • Adult Health Nurse Practitioner
  • Windsor, CT
National Provider Identifier
1669946588
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
8056 Issued in CT
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

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190523000473 CT Practitioner - Nurse Practitioner 0941543557 Reassigns benefits to 5 organizations

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
HDC Care Solutions LLCGroup PAC ID 0345634770, 190 clinicians

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

LicenseStateTypeSpecialty
8056CTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alignmed Partners, PC CurrentSince May 4, 2019 Accepting new patients
Careconnectmd Connecticut PC CurrentSince Jun 21, 2023 Accepting new patients
Value Based Long Term Care H PC CurrentSince May 1, 2025 Accepting new patients
Healthdrive Medical Services Southeast LLC Nurse Practitioner CurrentSince Aug 1, 2025 Accepting new patients
HDC Care Solutions, LLC Nurse Practitioner CurrentSince Jun 18, 2022 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.

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

Verify at the official NPI Registry.