Individual provider Active NPI

Helen Omolasho Okundaye, CRNP; PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1770968224
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R194865 Issued in MD
Practice address
1633 Renaissance Dr
Baltimore, MD 21221-2624
Phone
(443) 600-5477
Fax
(443) 231-5397
NPI assigned
Jul 27, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 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 R194865 MD Primary

Addresses

Primary practice location

1633 Renaissance Dr
Baltimore, MD 21221-2624

Mailing address

1633 Renaissance Dr
Baltimore, MD 21221-2624
Phone (443) 600-5477

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
I20230613002403 MD Practitioner - Nurse Practitioner 3072970631 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1633 Renaissance Dr
Essex, MD 21221-2624
Phone (443) 600-5477

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy First Healthcare Solutions Inc. PastSince Mar 19, 2023 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1437955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1770968224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1633 RENAISSANCE DR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212212624",
            "telephone_number": "443-600-5477",
            "fax_number": "443-231-5397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 RENAISSANCE DR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212212624",
            "telephone_number": "443-600-5477",
            "fax_number": "443-231-5397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKUNDAYE",
        "first_name": "HELEN",
        "middle_name": "OMOLASHO",
        "name_prefix": "Ms.",
        "credential": "CRNP; PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-27",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R194865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.