Jubril Alade Adediran, PMHNP-BC, DNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

202214466NP Issued in OR

Practice address

7615 Aimua CT
Houston, TX 77083-3741

Phone

(713) 992-5685

NPI assigned

May 27, 2019

Last updated

Dec 28, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX, OR, WA3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mindful Therapy Group PCGroup PAC ID 4981872561, 654 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Mindful Therapy Group PC

  dba Mindful Therapy Group

  • Clinical Social Worker
  • Mountlake Terrace, WA
  • NPI 1316238678

  OR, Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Reyoni Insights, LLC

  dba Sublime Behavioral and Wellness Clinic

  • Psychiatric/Mental Health Nurse Practitioner
  • Sugar Land, TX
  • NPI 1982358453

  OR

  Medicare reassignment Authorized official
• DHS/Office of Financial Services Irs/Eopc/BMRC/Eotc/Osh/Osh-P

  dba Oregon State Hospital (Salem)

  • Psychiatric Hospital
  • Salem, OR
  • NPI 1508802489
  Medicare reassignment NPD
• Sunray Psychiatry and Mental Healthcare LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Salem, OR
  • NPI 1851140883
  Medicare reassignment NPD
• Jalstad Ventures Incorporated

  dba Jalstad Healthcare Services

  • Home Health Agency
  • Houston, TX
  • NPI 1376579771
  NPD
• Medvon Medical Clinic Professional Corporation

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1407513443
  NPD (past)

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

{
    "created_epoch": "1558915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1720645666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7615 AIMUA CT",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770833741",
            "telephone_number": "713-992-5685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7615 AIMUA CT",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770833741",
            "telephone_number": "713-992-5685"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15500 Voss Rd",
            "address_purpose": "LOCATION",
            "city": "Sugar Land",
            "state": "TX",
            "postal_code": "774984601",
            "country_code": "US",
            "telephone_number": "832-405-4402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADEDIRAN",
        "first_name": "JUBRIL",
        "middle_name": "ALADE",
        "credential": "PMHNP-BC, DNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-27",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OR",
            "license": "202214179RN",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP141677",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP141677",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "202214466NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH ID",
            "identifier": "14474670",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500813853",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olabisi M Adebowale, NP
• Adebreen Group
• Abosede Comfort Adedapo, NP
• Raymond T Adedapo, MD
• Jennifer Nkiruka Adedayo-Ojo, NP
• Harriet Sumbo Adedoyin-Tuyo, NP
• Aderonke Adefisayo, M.D
• Alexander Anthony Adegbembo, COTA
• Aishat Bolatito Adegbenro
• Comfort Adegbite

• Psychiatric/Mental Health Nurse Practitioner in Houston, TX
• Providers in Houston, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2023; 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.