Omodele Cordero

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

4024 Central Ave
St Petersburg, FL 33711-1239

Phone

(727) 327-7656

Fax

(727) 322-2103

NPI assigned

May 20, 2021

Last updated

May 20, 2021By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Group practices

Tampa Bay Area CounselingGroup PAC ID 5193176006, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Tampa Bay Area Counseling

  dba TBAC Group

  • Mental Health Counselor
  • Tampa, FL
  • NPI 1508409319
  Medicare reassignment Care Compare group NPD
• Mindmetrics

  • Mental Health Counselor
  • Palm Harbor, FL
  • NPI 1477302727
  NPD (past)

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

{
    "created_epoch": "1621468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1699349910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10970",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337330970",
            "telephone_number": "727-327-7656",
            "fax_number": "727-322-2103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4024 CENTRAL AVE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337111239",
            "telephone_number": "727-327-7656",
            "fax_number": "727-322-2103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDERO",
        "first_name": "OMODELE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-20",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "suncoastcenter.org",
            "affiliation": "N",
            "address_1": "4024 Central Ave",
            "city": "St Petersburg",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337111239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Corazon Medico LLC
• Maureen Mary Corbett, PH.D.
• Martha Rosa Cordoba-Fabelo, MD
• Core Care Group Home LLC
• Coremed Supply LLC
• Mary Antoinette Corey, ARNP
• Madison Coriarty

• Mental Health Counselor in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; 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.