Mr Samuel Olaoluwa Omolade, APRN PMHNP in Dallas, TX - Medicare Nurse Practitioner

Mr Samuel Olaoluwa Omolade, APRN PMHNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Dallas, Texas. His current practice location is 11650 Mccree Rd, Dallas, Texas. You can reach out to his office (for appointments etc.) via phone at (718) 304-4906.

Mr Samuel Olaoluwa Omolade is licensed to practice in Texas (license number 1099855) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1548799141.

Contact Information

	Mr Samuel Olaoluwa Omolade, APRN PMHNP
	11650 Mccree Rd, Dallas, TX 75238-5224
	(718) 304-4906
	Not Available

Provider's Profile

Full Name	Mr Samuel Olaoluwa Omolade
Gender	Male
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	11650 Mccree Rd, Dallas, Texas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1548799141
Provider Enumeration Date: 06/07/2017
Last Update Date: 07/15/2023

Medicare PECOS Information:

PECOS PAC ID: 3577938281
Enrollment ID: I20230412000086

Medical Identifiers

Medical identifiers for Mr Samuel Olaoluwa Omolade such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1548799141	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
164W00000X	Licensed Practical Nurse	320878-1 (New York)	Secondary
163WA2000X	Registered Nurse - Administrator	958104 (Texas)	Secondary
171M00000X	Case Manager/care Coordinator	958104 (Texas)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	AP61366158 (Washington)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	1099855 (Texas)	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. Mr Samuel Olaoluwa Omolade allows following entities to bill medicare on his behalf.

Entity Name	Kinghaven Counseling Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1396807350 PECOS PAC ID: 5597898510 Enrollment ID: O20100728000390

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Entity Name	Grow Healthcare Group Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20220525002138

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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. Mr Samuel Olaoluwa Omolade 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
Mr Samuel Olaoluwa Omolade, APRN PMHNP 11650 Mccree Rd Apt 2034, Dallas, TX 75238-3245 Ph: (718) 304-4906	Mr Samuel Olaoluwa Omolade, APRN PMHNP 11650 Mccree Rd, Dallas, TX 75238-5224 Ph: (718) 304-4906

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Nurse Practitioner Nurses in Dallas, TX

Mrs. Darleen Dansby, APN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1513 Viceroy Dr, Dallas, TX 75235 Phone: 469-685-7020 Fax: 214-920-7020
Ms. Kimberley Shenee Player, MSN, APRN, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 8604 Greenville Ave Ste 103a, Dallas, TX 75243 Phone: 214-702-5855
Teresa Anna Jones, CPNP-AC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1935 Medical District Dr, Dallas, TX 75235 Phone: 973-801-0173
Christina Hagood, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 6301 Gaston Ave, Suite 100, West Tower, Dallas, TX 75214 Phone: 214-827-3610 Fax: 214-821-4017
Susan C. Chesire, ANP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3600 Gaston Ave, Wadley Tower, Suite 651, Dallas, TX 75246 Phone: 214-820-9115 Fax: 214-820-9135
Mrs. Larah Brown, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3209 W Camp Wisdom Rd, Dallas, TX 75237 Phone: 469-966-9660 Fax: 877-667-6112
Michele Willet Rylander, RN, MSN, CPNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1935 Medical District Dr, Dallas, TX 75235 Phone: 214-456-7000

Mr Samuel Olaoluwa Omolade, APRN PMHNP - Medicare Nurse Practitioner in Dallas, TX

Contact Information

Provider's Profile

Medical Identifiers

Medical Taxonomies and Licenses

Medicare Reassignments

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Medicare Part D Prescriber Enrollment

Mailing Address and Practice Location

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Nurse Practitioner Nurses in Dallas, TX