Individual provider Active NPI

Olalekan Iyiola Ajayi

  • Psychiatric/Mental Health Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1962087627
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R183252 Issued in MD
Practice address
2401 W Belvedere Ave
Baltimore, MD 21215-5216
Phone
(410) 601-5610
NPI assigned
Mar 15, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R183252 MD Primary

Addresses

Primary practice location

2401 W Belvedere Ave
Baltimore, MD 21215-5216

Mailing address

11513 Lipscomb Way
White Marsh, MD 21162-3425
Phone (443) 925-9555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20210913000836 MD Practitioner - Nurse Practitioner 7911303292 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Balance Point Wellness LLCGroup PAC ID 9931521556, 36 clinicians

Practice addresses (Care Compare)

11 Ctr PL
Suite 201
Dundalk, MD 21222-4377
Phone (410) 870-6037

11350 McCormick Rd
Hunt Valley, MD 21031-1002
Phone (410) 800-2169

8606 Harford Rd
Parkville, MD 21234-4657
Phone (410) 870-6037

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R183252MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Mind Wellness Psychiatric/Mental Health Current Accepting new patients
Infinite Mind Wellness CurrentSince Jun 1, 2022 Accepting new patients
Balance Point Wellness, LLC CurrentSince Sep 7, 2021 Accepting new patients
Legacy Aspire Healthcare Current Accepting new patients

Locations

5820 York Rd
Ste 201
Baltimore, MD 21212
Phone (410) 365-0693

2015 Emmorton Rd
Ste 201
Bel Air, MD 21015
Phone 41080021695740

11350 McCormick Rd
Hunt Valley, MD 21031
Phone (410) 258-4721

7658 Belair Rd
Nottingham, MD 21236
Phone (410) 701-0012

212 W Main St
Ste 303
Salisbury, MD 21801
Phone (410) 401-8075

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": "1615766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1962087627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11513 LIPSCOMB WAY",
            "city": "WHITE MARSH",
            "state": "MD",
            "postal_code": "211623425",
            "telephone_number": "443-925-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W BELVEDERE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155216",
            "telephone_number": "410-601-5610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJAYI",
        "first_name": "OLALEKAN",
        "middle_name": "IYIOLA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-15",
        "last_updated": "2021-03-15",
        "certification_date": "2021-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R183252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.