Individual provider Active NPI

Maryam Oladejo

  • Psychiatric/Mental Health Nurse Practitioner
  • Stafford, TX
National Provider Identifier
1770288102
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1113828 Issued in TX
Practice address
3727 Greenbriar Dr Ste 114
Stafford, TX 77477-3929
Phone
(281) 385-8554
NPI assigned
Apr 4, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1113828 TX Primary

Addresses

Primary practice location

3727 Greenbriar Dr Ste 114
Stafford, TX 77477-3929

Mailing address

3727 Greenbriar Dr Ste 114
Stafford, TX 77477-3929
Phone (281) 385-8554

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20230918000633 TX Practitioner - Nurse Practitioner 0143684639 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
Texana CenterGroup PAC ID 7618963265, 23 clinicians

Practice addresses (Care Compare)

4910 Airport Ave
Suite D
Rosenberg, TX 77471-5759
Phone (281) 239-1300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1113828TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texana Center CurrentSince Aug 16, 2023 Accepting new patients

Locations

4910 Airport Ave
Ste D
Rosenberg, TX 77471
Phone (281) 239-1300

Interoperability endpoints

  • Direct secure messaging: maryam.oladejo.1@26473.direct.athenahealth.com

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": "1680566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1770288102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3727 GREENBRIAR DR STE 114",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774773929",
            "telephone_number": "281-385-8554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3727 GREENBRIAR DR STE 114",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774773929",
            "telephone_number": "281-385-8554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLADEJO",
        "first_name": "MARYAM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-04",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1113828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, TX

Sources for this page

Verify at the official NPI Registry.