Omoniyi Tunde Modupe, DNP-CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

26NJ15060600 Issued in NJ

Practice address

1 Cooper PLZ Dept of
Camden, NJ 08103-1461

Phone

(856) 342-2425

NPI assigned

Oct 1, 2021

Last updated

Oct 22, 2024By the provider in NPPES

Sex

Male

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 PA, NJ2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rgal Anesthesia Services LLCGroup PAC ID 7517130602, 126 clinicians

Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Society Hill Anesthesia Consultants PCGroup PAC ID 5991617292, 210 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Temple University Hospital Hospital, Philadelphia, PA, CCN 390027
• Phoenixville Hospital Hospital, Phoenixville, PA, CCN 390127

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rgal Anesthesia Services LLC

  • Anesthesiology Physician
  • Lancaster, PA
  • NPI 1699055251
  Medicare reassignment Care Compare group NPD
• Society Hill Anesthesia Consultants, PC

  • Anesthesiology Physician
  • Philadelphia, PA
  • NPI 1427003219
  Medicare reassignment Care Compare group NPD
• Temple Faculty Practice Plan Inc

  dba Temple Faculty Anesthesiology Associates

  • Anesthesiology Physician
  • Philadelphia, PA
  • NPI 1881176949
  Medicare reassignment Care Compare group NPD
• Cooper Anesthesia Associates, PC

  • Anesthesiology Physician
  • Camden, NJ
  • NPI 1447207147
  Medicare reassignment NPD
• North American Partners in Anesthesia, Pennsylvania , LLC

  • Anesthesiology Physician
  • Melville, NY
  • NPI 1639137854

  Nurse Anesthetist, Certified Registered, PA

  Medicare reassignment NPD
• Northstar Anesthesia of Pennsylvania, LLC

  • Anesthesiology Physician
  • Darby, PA
  • NPI 1700218989

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Temple Faculty Practice Plan Inc

  dba Temple Faculty Multi-Specialty at NJ

  • Urology Physician
  • Voorhees, NJ
  • NPI 1407638794
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Phoenixville Hospital, LLC

  dba Phoenixville Hospital

  • General Acute Care Hospital
  • Phoenixville, PA
  • NPI 1750805552
  Care Compare affiliation
• Temple University Hospital, Inc

  dba The Temple University Hospital Fox Chase Cancer Center Buckingham Outp

  • Clinic/Center
  • Furlong, PA
  • NPI 1093404386

  Hospital

  Care Compare affiliation
• Temple University Hospital, Inc

  dba Temple University Hospital-Fox Chase Outpatient Department

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1275157455
  Care Compare affiliation
• Temple University Hospital, Inc

  • Ambulatory Surgical Clinic/Center
  • Philadelphia, PA
  • NPI 1275682148

  Hospital

  Care Compare affiliation
• Temple University Hospital, Inc

  dba Temple University Hospital - Jeanes Campus

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1356981443
  Care Compare affiliation
• Temple University Hospital, Inc

  dba Temple University Hospital Fox Chase Cancer Center East Norriton Outpa

  • Clinic/Center
  • East Norriton, PA
  • NPI 1407612922

  Hospital

  Care Compare affiliation
• Temple University Hospital, Inc

  dba Temple University Hospital Fox Chase Cancer Center at Chestnut Hill Ho

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1871368654
  Care Compare affiliation
• Temple University Hospital, Inc

  dba Temple Women and Families Hospital

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1932813789
  Care Compare affiliation
• Temple University Hospital, Inc

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1962579029
  Care Compare affiliation

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

{
    "created_epoch": "1633046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1942972690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST STE 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "482-886-9358",
            "fax_number": "732-790-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COOPER PLZ DEPT OF",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031461",
            "telephone_number": "856-342-2425"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 N Broad St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191405103",
            "country_code": "US",
            "telephone_number": "215-707-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MODUPE",
        "first_name": "OMONIYI",
        "middle_name": "TUNDE",
        "credential": "DNP-CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-01",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN685335",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NJ15060600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria A Miyamoto, MSW, LSW
• Ryan J Moazamian, MD
• Matthew Christopher Moccia, MD
• Parag Modi, MD
• Priya Modi
• Meghana Mogalipuvvu
• Zacharia Mohamed
• Nasarullah Mohammed, RPH
• Safwan Mohammed Mohiuddin, MD
• Ankit Mohla, DO, MS

• Certified Registered Nurse Anesthetist in Camden, NJ
• Providers in Camden, NJ by specialty
• Certified Registered Nurse Anesthetist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.