Individual provider Active NPI

Ayoola Juliana Oyenuga, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Upper Marlboro, MD
National Provider Identifier
1982172664
Registry record updated Nov 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
189802 Issued in MD
Practice address
2014 Whistling Duck Dr
Upper Marlboro, MD 20774-7139
Phone
(240) 821-2195
NPI assigned
Nov 11, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2018

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 189802 MD Primary

Addresses

Primary practice location

2014 Whistling Duck Dr
Upper Marlboro, MD 20774-7139

Mailing address

2014 Whistling Duck Dr
Upper Marlboro, MD 20774-7139
Phone (240) 821-2195

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 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
I20190604001052 MD Practitioner - Nurse Practitioner 6204169469 Reassigns benefits to 2 organizations
I20221219000299 DC Practitioner - Nurse Practitioner 6204169469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1800 N Charles St
Suite 408
Baltimore, MD 21201-5909
Phone (240) 821-2195

9701 Apollo Dr
Suite 293
Upper Marlboro, MD 20774-4789
Phone (240) 821-2195

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
189802MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Supportive Care of Maryland LLC CurrentSince Aug 1, 2021 Accepting new patients
Aglow Recovery Healthcare Services Psychiatric/Mental Health CurrentSince Jan 1, 2023 Accepting new patients
Alpha Recovery Healthcare Services Inc. Psychiatric/Mental Health Past Accepting new patients
Alpha Recovery Healthcare Services Inc Psychiatric/Mental Health Past Accepting new patients

Locations

2490 Market St NE
Washington, DC 20018
Phone (202) 679-4212

1647 Benning Rd NE
Ste 300A
Washington, DC 20002
Phone (202) 388-3801

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

Organizations & group practices 5

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": "1541894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541894400000",
    "number": "1982172664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2014 WHISTLING DUCK DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207747139",
            "telephone_number": "240-821-2195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2014 WHISTLING DUCK DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207747139",
            "telephone_number": "240-821-2195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OYENUGA",
        "first_name": "AYOOLA",
        "middle_name": "JULIANA",
        "name_prefix": "Dr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-11",
        "last_updated": "2018-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "189802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Marlboro, MD

Sources for this page

Verify at the official NPI Registry.