Individual provider Active NPI

Beauty Olusoga

  • Women's Health Nurse Practitioner
  • Newark, NJ
National Provider Identifier
1861078701
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
26NJ00830100 Issued in NJ
Practice address
741 Broadway
Newark, NJ 07104-4309
Phone
(973) 483-1300
NPI assigned
Mar 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 26NJ00830100 NJ Primary

Addresses

Primary practice location

741 Broadway
Newark, NJ 07104-4309

Mailing address

2247 Balmoral Ave
Union, NJ 07083-5203
Phone (908) 247-8788

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
I20210412000118 NJ Practitioner - Nurse Practitioner 0547678617 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00830100NJMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Peter'S University Hospital CurrentSince Apr 8, 2024 Accepting new patients
Newark Community Health Centers, Inc. Current Accepting new patients
Newark Community Health Centers, Inc CurrentSince Apr 1, 2021 Accepting new patients
Saint Peter'S University Hospital CurrentSince Apr 8, 2024 Accepting new patients

Locations

254 Easton Ave
New Brunswick, NJ 08901
Phone (732) 565-5453

123 How Ln
New Brunswick, NJ 08901
Phone (732) 448-1000

741 Broadway
Newark, NJ 07104
Phone (973) 483-1300

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HBFIAA
  • Direct secure messaging: beauty.olusoga.1@8568.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/8568/brand/1/csg/1/fhir/r4

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": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1861078701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2247 BALMORAL AVE",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070835203",
            "telephone_number": "908-247-8788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 BROADWAY",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071044309",
            "telephone_number": "973-483-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLUSOGA",
        "first_name": "BEAUTY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-22",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NJ",
            "license": "26NJ00830100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.