Modupeore Ajibade

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ15019300 Issued in NJ

Practice address

1945 Morris Ave Ste 7
Union, NJ 07083

Phone

(908) 291-2727

NPI assigned

Apr 1, 2024

Last updated

May 7, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Bridgeway Behavioral Health ServicesGroup PAC ID 1658699715, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ajibade.modupeore.p1@direct.nhscnj.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bridgeway Behavioral Health Services

  • Community/Behavioral Health Agency
  • Elizabeth, NJ
  • NPI 1639294879
  Medicare reassignment Care Compare group
• Bridgeway Behavioral Health Services

  • Community/Behavioral Health Agency
  • Union, NJ
  • NPI 1386781920
  NPD
• Jersey Behavioral Care LLC

  • Mental Health Counselor
  • Union, NJ
  • NPI 1740677152
  NPD
• Jersey Behavioral Care LLC

  dba NJP counseling center

  • Mental Health Counselor
  • Somerset, NJ
  • NPI 1043853328
  NPD (past)

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

{
    "created_epoch": "1711929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1689425340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 MORRIS AVE STE 7",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070833518",
            "telephone_number": "908-291-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 MORRIS AVE STE 7",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "07083",
            "telephone_number": "908-291-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJIBADE",
        "first_name": "MODUPEORE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-01",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ15019300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasleen Ahuja
• Lateef Ajanaku-Makun, APN
• Adebola Ajanaku
• Shiyanbola Ajao
• Juliet Ajayi
• Ajt Behavioral Therapy Inc
• Nneka Gloria Akaeme, PHARM.D.
• Tahira Akbar, M.D.
• Bosede Janet Akilo
• Ifeoluwa Akindunbi, APN

• Psychiatric/Mental Health Nurse Practitioner in Union, NJ
• Providers in Union, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

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