Individual provider Active NPI

Michael Ajayi, RN, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Marlton, NJ
National Provider Identifier
1801124599
Registry record updated Mar 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ01081000 Issued in NJ
Practice address
765 Route 70 E BLDG A100
Marlton, NJ 08053-2341
Phone
(856) 983-3900
Fax
(856) 797-4785
NPI assigned
Nov 18, 2009
Last updated
Mar 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 30 305107 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ01081000 NJ Primary

Addresses

Primary practice location

765 Route 70 E BLDG A100
Marlton, NJ 08053-2341

Mailing address

765 Route 70 E BLDG A100
Marlton, NJ 08053-2341
Phone (856) 983-3900

Other practice location 1

791 Holly Pl
Rahway, NJ 07065-4914
Phone (646) 287-8242

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL credentialing@cfgpc.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20210315000265 NJ Practitioner - Nurse Practitioner 1951717156 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Family Guidance PCGroup PAC ID 2860396454, 164 clinicians

Practice addresses (Care Compare)

1317 S Main Rd
Suite 2a
Vineland, NJ 08360-6511
Phone (856) 553-2755

301 Spring Garden Rd
Hammonton, NJ 08037-2516
Phone (609) 561-1700

765 Route 70 E
BLDG a
Marlton, NJ 08053-2341
Phone (856) 983-3900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30 305107NYMDAdult Health Nurse Practitioner
26NJ01081000NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oakland Integrated Care Network LLC Psychiatric/Mental Health CurrentSince Nov 25, 2022 Accepting new patients
State of New Jersey Omb Centralized Payroll CurrentSince Dec 10, 2020 Accepting new patients
Center for Family Guidance, PC Psychiatric/Mental Health CurrentSince Feb 1, 2022 Accepting new patients
State of New Jersey Omb Centralized Payroll CurrentSince Dec 10, 2020 Accepting new patients
St Remi LLC CurrentSince Jun 1, 2021 Accepting new patients

Locations

333 Irving Ave
Bridgeton, NJ 08302
Phone (856) 575-4500

301 Spring Garden Rd
Hammonton, NJ 08037
Phone (609) 561-1700

750 Route 73 S
Ste 105A
Marlton, NJ 08053
Phone (609) 417-7300

765 Route 70 E
Bldg A
Marlton, NJ 08053
Phone (856) 797-4721

521 Sicklerville Rd
Ste 3C
Sicklerville, NJ 08081
Phone (856) 553-8724

1317 S Main Rd
Ste 2A
Vineland, NJ 08360
Phone (856) 553-2755

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: michael.ajayiapn.p1@direct.cfg.nextgenshare.com

Organizations & group practices 5

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": "1258502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1801124599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 ROUTE 70 E BLDG A100",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080532341",
            "telephone_number": "856-983-3900",
            "fax_number": "856-797-4785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 ROUTE 70 E BLDG A100",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080532341",
            "telephone_number": "856-983-3900",
            "fax_number": "856-797-4785"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "791 Holly Pl",
            "address_purpose": "LOCATION",
            "city": "Rahway",
            "state": "NJ",
            "postal_code": "070654914",
            "country_code": "US",
            "telephone_number": "646-287-8242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AJAYI",
        "first_name": "MICHAEL",
        "credential": "RN, NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-18",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "30 305107",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ01081000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "credentialing@cfgpc.com",
            "affiliation": "N",
            "address_1": "765 Route 70 E Bldg A100",
            "city": "Marlton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080532341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

Verify at the official NPI Registry.