Individual provider Active NPI

Juliana Oluwatosin Adetola, FNP-C

  • Family Medicine Physician
  • Sacramento, CA
National Provider Identifier
1740963198
Registry record updated Aug 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
95026500 Issued in CA
Practice address
2710 Gateway Oaks Dr
Sacramento, CA 95833-3505
Phone
(916) 646-2770
NPI assigned
Aug 11, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 95026500 CA Primary

Addresses

Primary practice location

2710 Gateway Oaks Dr
Sacramento, CA 95833-3505

Mailing address

2710 Gateway Oaks Dr
Sacramento, CA 95833-3505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20240816003778 MD Practitioner - Nurse Practitioner 9830637198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hollis Seunarine Mdpa LLCGroup PAC ID 4183608573, 19 clinicians

Practice addresses (Care Compare)

5010 York Rd
Baltimore, MD 21212-4444
Phone (410) 433-2200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95026500CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hollis Seunarine Mdpa LLC Family Medicine CurrentSince Jul 15, 2024 Accepting new patients

Locations

5010 York Rd
Baltimore, MD 21212
Phone (410) 433-2200

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1691712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1740963198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 GATEWAY OAKS DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958333505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 GATEWAY OAKS DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958333505",
            "telephone_number": "916-646-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADETOLA",
        "first_name": "JULIANA",
        "middle_name": "OLUWATOSIN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-11",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "95026500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.