Olukemi Roseline Omogoke, MD

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R207593 Issued in MD

Practice address

650 Ritchie Hwy Ste 207
Severna Park, MD 21146-3935

Phone

(410) 315-9350

Fax

(410) 421-9135

NPI assigned

Nov 21, 2018

Last updated

Mar 26, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, MD2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Optum Behavioral Care of North Carolina PCGroup PAC ID 5092120030, 175 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Nurse Practitioner

Practice roles

Locations

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.

• Optum Behavioral Care of North Carolina, PC

  • Counseling Psychologist
  • Columbia, MD
  • NPI 1518732833
  Medicare reassignment Care Compare group NPD
• Zenith Psychiatric & Mental Health Services

  dba Zenith Psychiatric Services

  • Psychiatric/Mental Health Nurse Practitioner
  • Bowie, MD
  • NPI 1144941766

  DC

  Medicare reassignment NPD Authorized official
• Royal Minds Inc.

  dba Royal Minds Rehabilitation Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
  • NPI 1659934503
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  DC, Psychiatric/Mental Health

  Medicare reassignment NPD
• Wisconsin Ave Psychiatric Center Inc

  dba Psychiatric Institute of Washington

  • Psychiatric Hospital
  • Washington, DC
  • NPI 1871549949

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Optum Behavioral Care of North Carolina, P.C.

  • Clinical Social Worker
  • Mount Airy, MD
  • NPI 1679467138
  NPD
• Optum Behavioral Care of North Carolina, P.C.

  • Clinical Social Worker
  • Gulfport, MS
  • NPI 1861371718
  NPD
• Royal Minds Inc

  • Community/Behavioral Health Agency
  • Greensboro, NC
  • NPI 1558096487
  NPD

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

{
    "created_epoch": "1542758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1801365689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12804 GREENES PROMISE CT",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207205613",
            "telephone_number": "301-346-2201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 RITCHIE HWY STE 207",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211463935",
            "telephone_number": "410-315-9350",
            "fax_number": "410-421-9135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMOGOKE",
        "first_name": "OLUKEMI",
        "middle_name": "ROSELINE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-21",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R207593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Severna Park, MD
• Providers in Severna Park, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.