Abimbola Otufale, PMHNP in Atlanta, GA - Medicare Nurse Practitioner

Abimbola Otufale, PMHNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Atlanta, Georgia. Her current practice location is Po Box 748465, Atlanta, Georgia. You can reach out to her office (for appointments etc.) via phone at (855) 284-7483.

Abimbola Otufale is licensed to practice in New Jersey (license number 26NJ01068500) 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 1508464397.

Contact Information

	Abimbola Otufale, PMHNP
	Po Box 748465, Atlanta, GA 30374-8465
	(855) 284-7483
	Not Available

Map and Direction

Provider's Profile

Full Name	Abimbola Otufale
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	Po Box 748465, Atlanta, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1508464397
Provider Enumeration Date: 10/13/2020
Last Update Date: 04/30/2025

Medicare PECOS Information:

PECOS PAC ID: 8426451279
Enrollment ID: I20210730001918

Medical Identifiers

Medical identifiers for Abimbola Otufale such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1508464397	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	26NJ01068500 (New Jersey)	Primary
363LF0000X	Nurse Practitioner - Family	346031 (New York)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	C-APN.0102715-C-NP (Colorado)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	405429 (New York)	Secondary
363L00000X	Nurse Practitioner	1161913 (Texas)	Secondary

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. Abimbola Otufale allows following entities to bill medicare on her behalf.

Entity Name	Ks Medical, Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1295131506 PECOS PAC ID: 7618291683 Enrollment ID: O20150122000241

Entity Name	Wellcare Of Bx Medical Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1851848618 PECOS PAC ID: 5890040166 Enrollment ID: O20180611001867

Entity Name	Valera Medical Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1437782349 PECOS PAC ID: 0547690521 Enrollment ID: O20200414003279

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. Abimbola Otufale 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
Abimbola Otufale, PMHNP 252b Camden St, Newark, NJ 07103-2434 Ph: () -	Abimbola Otufale, PMHNP Po Box 748465, Atlanta, GA 30374-8465 Ph: (855) 284-7483

Reviews and Comments

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Abimbola Otufale, PMHNP - Medicare Nurse Practitioner in Atlanta, GA