Olanrewaju Oludotun Onifade, VA, DC, MD

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN2372522 Issued in MA

Practice address

75 Fenwood Rd
Boston, MA 02115-6103

Phone

(617) 626-9703

Fax

(617) 626-9703

NPI assigned

Aug 30, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DC, VA, MA3 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Nurse Practitioner

State licenses

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 and National Provider Directory roles.

• The Commonwealth of Massachusetts

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Boston, MA
  • NPI 1568587913
  Medicare reassignment NPD
• Psychogeriatric Services LLC

  • Psychiatry Physician
  • Columbia, MD
  • NPI 1588689483

  DC, VA

  Medicare reassignment NPD
• The Commonwealth of Massachusetts

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Boston, MA
  • NPI 1073638805
  NPD
• The Commonwealth of Massachusetts

  • General Acute Care Hospital
  • Holyoke, MA
  • NPI 1427111574
  NPD

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

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1881362515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24017 AUDUBON TRAIL DR",
            "city": "ALDIE",
            "state": "VA",
            "postal_code": "201055921",
            "telephone_number": "571-218-5326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FENWOOD RD",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156103",
            "telephone_number": "617-626-9703",
            "fax_number": "617-626-9703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONIFADE",
        "first_name": "OLANREWAJU",
        "middle_name": "OLUDOTUN",
        "credential": "VA, DC, MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-30",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2372522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0024182548",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret Li-Ting Ong, MD
• Rebecca Ong
• Theodore Joseph Ongaro, MD
• Obiageli Oniah
• Mawakana Onifade
• Allison Michelle Onken
• Online Care Group PC
• Online Care Network II PC
• Online Care Network II PC
• Yuho Ono, MD

• Psychiatric/Mental Health Nurse Practitioner in Boston, MA
• Providers in Boston, MA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.