Mobolaji Rosanwo, DNP CRNP PHMNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R223563 Issued in MD

Practice address

418 Broadway Ste N
Albany, NY 12207-2922

Phone

(443) 858-1968

NPI assigned

May 13, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, MD, 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

Valera Medical PCGroup PAC ID 0547690521, 160 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 and National Provider Directory roles.

• Valera Medical, P.C.

  • Psychiatry Physician
  • Brooklyn, NY
  • NPI 1437782349

  WA

  Medicare reassignment Care Compare group NPD
• Goldb

  • Psychiatric/Mental Health Nurse Practitioner
  • Owings Mills, MD
  • NPI 1861115198
  Medicare reassignment Authorized official
• Multicare Health System

  dba Multicare Neurological Surgery

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment NPD
• Multicare Health System

  dba MultiCare Rockwood Imaging

  • Diagnostic Radiology Physician
  • Tacoma, WA
  • NPI 1285121442
  NPD
• Multicare Health System

  dba MultiCare Deaconess Retail Pharmacy

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD
• Brightside Medical, P.C.

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1801355482
  NPD (past)

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

{
    "created_epoch": "1620864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1730753989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 BROADWAY STE N",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122072922",
            "telephone_number": "443-858-1968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 BROADWAY STE N",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122072922",
            "telephone_number": "443-858-1968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSANWO",
        "first_name": "MOBOLAJI",
        "credential": "DNP CRNP PHMNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-13",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61358864",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "403963",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R223563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patti Rosa-Farleigh, M.S., CCC-SLP
• Allison Rosa, DPT
• Wyatt D'Emilia Jerome Rosa, PHD
• Carolyn Rosales
• Thomas Gerard Rosano
• Frances Athena Rosario, FNP
• Carl Rosati, M.D.
• Rose Mitchell Midwifery, PLLC
• Jordan Rose, DPT
• Nickayla Rose

• Psychiatric/Mental Health Nurse Practitioner in Albany, NY
• Providers in Albany, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; 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.