Olajumoke Omolola Jongbo, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

291899 Issued in AZ

Practice address

43713 W Cowpath Rd
Maricopa, AZ 85138-5662

Phone

(602) 865-9753

Fax

(702) 608-7752

NPI assigned

Jun 17, 2021

Last updated

May 24, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Jewish Family and Childrens ServiceGroup PAC ID 9234028671, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Jewish Family & Children's Service

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1023174455
  Medicare reassignment Care Compare group NPD
• Vita Bridge Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Goodyear, AZ
  • NPI 1952104622
  Medicare reassignment NPD Authorized official
• Jewish Family & Children's Service

  • Community/Behavioral Health Agency
  • Glendale, AZ
  • NPI 1316009145
  NPD
• Jewish Family & Children's Service

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1609939214
  NPD
• Jewish Family & Children's Service

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1801103841
  NPD (past)

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

{
    "created_epoch": "1623888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1881262509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43713 W COWPATH RD",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851385662",
            "telephone_number": "602-865-9753",
            "fax_number": "702-608-7752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43713 W COWPATH RD",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851385662",
            "telephone_number": "602-865-9753",
            "fax_number": "702-608-7752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONGBO",
        "first_name": "OLAJUMOKE",
        "middle_name": "OMOLOLA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-17",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "291899",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN204392",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dwyla Dean Jones
• Tyeasa Renae Jones, PMHNP-BC
• Taylor L Jump, DPT
• Megan Eileen Kahler, LPN
• Karen Kramarczyk DDS Family Dentistry of Maricopa
• Meena A Kasisa, DMD
• Ronny Kassees

• Psychiatric/Mental Health Nurse Practitioner in Maricopa, AZ
• Providers in Maricopa, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; 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.