Individual provider Active NPI

Omolara Oloye Adelusi, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • McKinney, TX
National Provider Identifier
1972847515
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1021681 Issued in TX
Practice address
307 S McDonald St Ste 500
McKinney, TX 75069-5625
Phone
(469) 461-7286
NPI assigned
Nov 20, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X C-APN.0003457-C-NP CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 403623 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 263319 AZ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1021681 TX Primary

Addresses

Primary practice location

307 S McDonald St Ste 500
McKinney, TX 75069-5625

Mailing address

307 S McDonald St Ste 500
McKinney, TX 75069-5625
Phone (469) 461-7286

Other identifiers 1

IdentifierTypeStateIssuer
9000200385MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, TX2 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

Enrollment IDStateProvider typePAC IDDetails
I20220624000693 CO Practitioner - Nurse Practitioner 6709265556 Reassigns benefits to 1 organization
I20231117001772 TX Practitioner - Nurse Practitioner 6709265556 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2727 Bryant St
Suite 550
Denver, CO 80211-4151
Phone (469) 461-7286

307 S McDonald St
Suite 500
McKinney, TX 75069-5625
Phone (469) 461-7286

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C-APN.0003457-C-NPCOMDPsychiatric/Mental Health Nurse Practitioner
403623NYMDPsychiatric/Mental Health Nurse Practitioner
1021681TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Crystal Mind Psychiatry and Counseling Psychiatric/Mental Health CurrentSince Nov 6, 2023 Accepting new patients
Collin Medical & Wellness Group PLLC CurrentSince Aug 13, 2023 Accepting new patients

Locations

13802 N Scottsdale Rd
Ste 151280
Scottsdale, AZ 85254
Phone (469) 461-7286

2727 Bryant St
Ste 550
Denver, CO 80211
Phone (469) 461-7286

307 S McDonald St
Ste 500
McKinney, TX 75069
Phone (469) 202-7572

Interoperability endpoints

  • Direct secure messaging: omolara.oloye-adelusi.2@15452.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/25728/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1353369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1972847515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 S MCDONALD ST STE 500",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750695625",
            "telephone_number": "469-461-7286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 S MCDONALD ST STE 500",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750695625",
            "telephone_number": "469-461-7286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLOYE ADELUSI",
        "first_name": "OMOLARA",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-20",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "C-APN.0003457-C-NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "403623",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "263319",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1021681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000200385",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McKinney, TX

Sources for this page

Verify at the official NPI Registry.