Individual provider Active NPI

John Adelaja Adeleye, CRNP-PMH

  • Psychiatric/Mental Health Nurse Practitioner
  • Riverdale, MD
National Provider Identifier
1780332106
Registry record updated Mar 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R140143 Issued in MD
Practice address
6801 Kenilworth Ave Ste 300S2
Riverdale, MD 20737-1331
Phone
(301) 512-9448
NPI assigned
Mar 15, 2022
Last updated
Mar 15, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2022

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 R140143 MD Primary

Addresses

Primary practice location

6801 Kenilworth Ave Ste 300S2
Riverdale, MD 20737-1331

Mailing address

6801 Kenilworth Ave Ste 300S2
Riverdale, MD 20737-1331
Phone (301) 512-9448

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20221209001630 DC Practitioner - Nurse Practitioner 9436528619 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
Group practices
Amazing Healthcare Clinic CorporationGroup PAC ID 6002233756, 2 clinicians

Practice addresses (Care Compare)

6495 New Hampshire Ave
A203
Hyattsville, MD 20783-3245
Phone (301) 798-5583

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
God Is Good Non-Emergency Medical Transportation LLC Current 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": "1647302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1780332106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 KENILWORTH AVE STE 300S2",
            "city": "RIVERDALE",
            "state": "MD",
            "postal_code": "207371331",
            "telephone_number": "301-512-9448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 KENILWORTH AVE STE 300S2",
            "city": "RIVERDALE",
            "state": "MD",
            "postal_code": "207371331",
            "telephone_number": "301-512-9448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADELEYE",
        "first_name": "JOHN",
        "middle_name": "ADELAJA",
        "credential": "CRNP-PMH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-15",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R140143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, MD

Sources for this page

Verify at the official NPI Registry.