Omolola Otubaga, NP - Medicare Nurse Practitioner in Fayetteville, GA

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Omolola Otubaga, NP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Fayetteville, Georgia. She graduated from nursing school in 2015 and has 9 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Mindset Healthcare Pc and her current practice location is 101 Beckett Ln, Ste. 304, Fayetteville, Georgia. You can reach out to her office (for appointments etc.) via phone at (770) 703-4448.

Omolola Otubaga is licensed to practice in Georgia (license number RN207871) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1033595566.

Contact Information

Omolola Otubaga, NP
101 Beckett Ln, Ste. 304,
Fayetteville, GA 30214-7155
(770) 703-4448
(770) 703-4038

Map and Direction




Provider's Profile

Full NameOmolola Otubaga
GenderFemale
SpecialityNurse Practitioner
Experience9 Years
Location101 Beckett Ln, Fayetteville, Georgia
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Omolola Otubaga graduated from nursing school in 2015
  NPI Data:
  • NPI Number: 1033595566
  • Provider Enumeration Date: 08/06/2015
  • Last Update Date: 04/25/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 3779863188
  • Enrollment ID: I20161130002356

Medical Identifiers

Medical identifiers for Omolola Otubaga such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1033595566NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0808XNurse Practitioner - Psychiatric/mental Health RN207871 (Georgia)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Mindset Healthcare Pc05475146062

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. Omolola Otubaga allows following entities to bill medicare on her behalf.
Entity NameMental Health Comprehensive Services
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1033321583
PECOS PAC ID: 0345331369
Enrollment ID: O20070806000614
Entity NameMindset Healthcare Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1285119925
PECOS PAC ID: 0547514606
Enrollment ID: O20181108002691

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. Omolola Otubaga 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 AddressPractice Location Address
Omolola Otubaga, NP
5465 Highway 42, 246,
Ellenwood, GA 30294-3928

Ph: (470) 646-3738		Omolola Otubaga, NP
101 Beckett Ln, Ste. 304,
Fayetteville, GA 30214-7155

Ph: (770) 703-4448

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.