Individual provider Active NPI

Adeola Rita Omoruyi, CRNP

  • Nurse Practitioner
  • Largo, MD
National Provider Identifier
1689430936
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R231913 Issued in MD
Practice address
901 Harry S Truman Dr N
Largo, MD 20774-5477
Phone
(240) 677-1000
NPI assigned
Feb 26, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN200006296 DC
Registered Nurse 163W00000X R231913 MD
Nurse Practitioner 363L00000X R231913 MD Primary

Addresses

Primary practice location

901 Harry S Truman Dr N
Largo, MD 20774-5477

Mailing address

11305 Old Prospect Hill Rd
Glenn Dale, MD 20769-9423
Phone (240) 354-9483

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20250417003281 DC Practitioner - Nurse Practitioner 8123541471 Reassigns benefits to 2 organizations
Practice locations: Glenn Dale, MD

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dimensions Healthcare Associates, IncGroup PAC ID 1557269743, 198 clinicians

Practice addresses (Care Compare)

11305 Old Prospect Hill Rd
Glenn Dale, MD 20769-9423
Phone (301) 851-9880

901 Harry S Truman Dr N
Upper Marlboro, MD 20774-5477
Phone (240) 677-3000

Hospital & facility affiliations

  • University of MD Capital Region Medical Center Hospital, Upper Marlboro, MD, CCN 210003

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN200006296DCMDRegistered Nurse
R231913MDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dimensions Health Associates Dba University of Maryland Capital Region CurrentSince Mar 1, 2025 Accepting new patients
Remediez LLC CurrentSince Oct 12, 2025 Accepting new patients
Dimensions Healthcare Associates, Inc. Current Accepting new patients

Locations

2900 Mercy Ln
Cheverly, MD 20785
Phone (301) 618-2010

900 Elkridge Landing Rd
Fl 2
Linthicum Heights, MD 21090
Phone (443) 462-5010

901 Harry S Truman Dr N
Uppr Marlboro, MD 20774
Phone (240) 677-0021

Interoperability endpoints

  • Direct secure messaging: aomoruyi644279@direct.umm.edu

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1689430936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11305 OLD PROSPECT HILL RD",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207699423",
            "telephone_number": "240-354-9483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 HARRY S TRUMAN DR N",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745477",
            "telephone_number": "240-677-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMORUYI",
        "first_name": "ADEOLA",
        "middle_name": "RITA",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-26",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DC",
            "license": "RN200006296",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R231913",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R231913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, MD

Sources for this page

Verify at the official NPI Registry.