Oluwatobi Emmanuel Menawonu, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP016600 Issued in PA

Practice address

2601 Holme Ave
Philadelphia, PA 19152-2007

Phone

(215) 335-6562

NPI assigned

May 19, 2016

Last updated

May 25, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Electronic endpoints 5

Medicare fee-for-service enrollment

Enrolled in PA, FL2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/16196/brand/1/csg/1/fhir/r4
• Direct secure messaging: omenawonu2019370@direct.trinity-health.org

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.

• KCS Medical Consulting LLC

  • Nurse Practitioner
  • Philadelphia, PA
  • NPI 1962160226
  Medicare reassignment Authorized official
• Temple Physicians Inc

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1942444088

  Multi-Specialty

  Medicare reassignment NPD
• The Milton S Hershey Medical Center Physicians Group

  • Orthopaedic Surgery Physician
  • Hershey, PA
  • NPI 1710951744

  Multi-Specialty

  Medicare reassignment NPD
• Trinity Health Mid-Atlantic Medical Group

  dba THMA MG Surgical Associates Holme

  • Surgery Physician
  • Langhorne, PA
  • NPI 1972982361

  Multi-Specialty

  Medicare reassignment NPD
• Advanced Inpatient Medicine Lehigh PC

  • Hospitalist Physician
  • Hanover, MD
  • NPI 1437537875

  Multi-Specialty, PA

  Medicare reassignment NPD
• KCS Medical Consulting LLC

  • Nurse Practitioner
  • Philadelphia, PA
  • NPI 1063179554

  Multi-Specialty

  NPD Authorized official
• KCS Medical Consulting LLC

  dba KCS Medical AND PSYCH Consulting LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Huntingdon Valley, PA
  • NPI 1376358952
  Authorized official Same address or phone
• Temple Physician Inc.

  • Internal Medicine Physician
  • Feasterville Trevose, PA
  • NPI 1174497366
  NPD
• Temple Physicians Inc

  • Cardiovascular Disease Physician
  • Philadelphia, PA
  • NPI 1083886188

  Multi-Specialty

  NPD
• The Milton S Hershey Medical Center Physician Group

  • Body Imaging Physician
  • Hershey, PA
  • NPI 1346215928

  Multi-Specialty

  NPD
• The Milton S Hershey Medical Center Physicians Group

  • Hematology & Oncology Physician
  • Hershey, PA
  • NPI 1427023159
  NPD
• Trinity Health Mid-Atlantic Medical Group

  • Physical Medicine & Rehabilitation Physician
  • Philadelphia, PA
  • NPI 1639039175

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1463616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1891142774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 LONGSHORE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191114538",
            "telephone_number": "215-834-3656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 HOLME AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191522007",
            "telephone_number": "215-335-6562"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1110 Longshore Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191114538",
            "country_code": "US",
            "telephone_number": "215-834-3656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENAWONU",
        "first_name": "OLUWATOBI",
        "middle_name": "EMMANUEL",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-19",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "2016001828",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "F0516014",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00684300",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP016600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "omenawonu169763@directvirtua.org",
            "affiliation": "N",
            "address_1": "175 Madison Ave",
            "city": "Mount Holly",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080602099",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "omenawonu169763@directvirtua.org",
            "affiliation": "N",
            "address_1": "1600 Haddon Ave",
            "city": "Camden",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "081033101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "omenawonu169763@directvirtua.org",
            "affiliation": "N",
            "address_1": "90 Brick Rd Fl 3",
            "city": "Marlton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080532177",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "omenawonu169763@directvirtua.org",
            "affiliation": "N",
            "address_1": "100 Bowman Dr Lowr Level1",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080439612",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "omenawonu169763@directvirtua.org",
            "affiliation": "N",
            "address_1": "218 Sunset Rd",
            "city": "Willingboro",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080461110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Larry W Menacker, DPM
• Leon B Menajovsky, M.D.
• Leonard Menaker, DPM
• Guerline Menard-Louis
• Menarini Silicon Biosystems, Inc.
• Menda Behavioral Health Services PC
• Adrienne Mendell, M.A.
• Alan Marc Mendelsohn, M.D.
• Ali Mendelson, MD
• Steven Mendelson

• Family Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 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.