Individual provider Active NPI

Ayesha Carmela Oglesby, FNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Beverly Hills, MI
National Provider Identifier
1811538978
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704280542 Issued in MI
Practice address
31140 Huntley SQ W Apt 412
Beverly Hills, MI 48025-5364
Phone
(313) 525-0214
NPI assigned
Sep 30, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704280542 MI Primary
Family Nurse Practitioner 363LF0000X 4704280542 MI

Addresses

Primary practice location

31140 Huntley SQ W Apt 412
Beverly Hills, MI 48025-5364

Mailing address

31140 Huntley SQ W Apt 412
Beverly Hills, MI 48025-5364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, CT, MS3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20220225001290 MI Practitioner - Nurse Practitioner 4789078247 Reassigns benefits to 3 organizations
I20250924001366 CT Practitioner - Nurse Practitioner 4789078247 Reassigns benefits to 1 organization
I20251203003698 MS Practitioner - Nurse Practitioner 4789078247 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

200 Oceangate
Suite 100
Long Beach, CA 90802-4316

31140 Huntley SQ W
Apt 412
Beverly Hills, MI 48025-5364

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704280542MIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC CurrentSince Jul 10, 2023 Accepting new patients
Vpa PC CurrentSince Mar 21, 2023 Accepting new patients
Molina Care Connections, LLC. CurrentSince Jun 16, 2025 Accepting new patients
Vpa PC CurrentSince Mar 21, 2023 Accepting new patients

Locations

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

175 Scott Swamp Rd
Farmington, CT 06032
Phone (860) 249-6752

500 Kirts Blvd
Ste 200
Troy, MI 48084
Phone (248) 824-6060

880 W Long Lake Rd
Troy, MI 48098
Phone (248) 227-6316

13 N Washington St
Ypsilanti, MI 48197
Phone (734) 329-4620

188 E Capitol St
Ste 700
Jackson, MS 39201
Phone (844) 809-8438

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: aoglesby19511@direct-prd.molinahealthcare.com

Organizations & group practices 4

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": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1811538978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31140 HUNTLEY SQ W APT 412",
            "city": "BEVERLY HILLS",
            "state": "MI",
            "postal_code": "480255364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31140 HUNTLEY SQ W APT 412",
            "city": "BEVERLY HILLS",
            "state": "MI",
            "postal_code": "480255364",
            "telephone_number": "313-525-0214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGLESBY",
        "first_name": "AYESHA",
        "middle_name": "CARMELA",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-30",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704280542",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704280542",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, MI

Sources for this page

Verify at the official NPI Registry.