Fausat Funmilola Odubiyi, NURSE PRACTITIONER is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Rancocas, New Jersey. Her current practice location is
215 Main Street, Rancocas, New Jersey. You can reach out to her office (for appointments etc.) via phone at
(609) 471-3560.
Fausat Funmilola Odubiyi is licensed to practice in New York (license number 402510) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1881174654.
Provider's Profile
Full Name | Fausat Funmilola Odubiyi |
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Gender | Female |
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Speciality | Nurse Practitioner - Psychiatric/mental Health |
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Location | 215 Main Street, Rancocas, New Jersey |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1881174654
- Provider Enumeration Date: 08/21/2018
- Last Update Date: 01/19/2024
Medicare PECOS Information:
- PECOS PAC ID: 0749603496
- Enrollment ID: I20200714000674
Medical Identifiers
Medical identifiers for Fausat Funmilola Odubiyi such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1881174654 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 26NR22474600 (New Jersey) | Secondary |
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 402510 (New York) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Fausat Funmilola Odubiyi allows following entities to bill medicare on her behalf.
Entity Name | Brooklyn Plaza Medical Center Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1336113398 PECOS PAC ID: 7113961178 Enrollment ID: O20170503000192 |
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Entity Name | Able Healthcare Nurse Practitioner In Pshchiatry Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1902508385 PECOS PAC ID: 9335513696 Enrollment ID: O20230328001881 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Fausat Funmilola Odubiyi is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Fausat Funmilola Odubiyi, NURSE PRACTITIONER 215 Main Street, Suite 2b, Rancocas, NJ 08073-2735 Ph: (609) 471-3560 | Fausat Funmilola Odubiyi, NURSE PRACTITIONER 215 Main Street, Rancocas, NJ 08073 Ph: (609) 471-3560 |
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