DR. TITILOPE OLAOLUWA OMISAKIN (DNP, APRN, CNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1407536345

DR. TITILOPE OLAOLUWA OMISAKIN (DNP, APRN, CNP) is a healthcare provider. based in Blaine, Minnesota. specializing in NURSE PRACTITIONER. They hold the professional credentials DNP, APRN, CNP. They hold a License No. 10421 (MN). The NPI Number for DR. TITILOPE OLAOLUWA OMISAKIN (DNP, APRN, CNP) is 1407536345

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
DR. TITILOPE OLAOLUWA OMISAKIN (DNP, APRN, CNP)
NPI
1407536345
Phone
(908) 374-8661
Address
1528 111TH DR NE UNIT D
Enumeration Date
24 July 2023
Last Update Date
24 July 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7635591640
Graduation Year
2023 (3 years ago)
PAC ID
6901252857
Group Practice PAC ID
6800103490
Professional Enrollment ID
I20231027003126
Address ID
MN554424507PL9655XRDXX401
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

5,720 NURSE PRACTITIONER in MN

Provider Addresses for DR. TITILOPE OLAOLUWA OMISAKIN (DNP, APRN, CNP)

  • 1528 111TH DR NE UNIT D

    BLAINE, MN 554494887

    Phone: (908) 374-8661

    Type: Mailing

  • 9655 SCHMIDT LAKE RD STE 150

    PLYMOUTH, MN 554424507

    Phone: (763) 559-1640

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 20 Open Payments records for all available years, with a total value of $369.

Total Amount is formed as General ($369) + Research ($0) + Ownership ($0) = $369.

Last reported payment date: 2024-11-11 • Largest payer in this snapshot: Tris Pharma Inc ($68).

Total Amount

$369

General + Research + Ownership

Payments

20

Total payment records

General Amount

$369

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-11

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-10-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231027003126INurse PractitionerMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55449)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6800103490View full group profile
NameSpecialtyState
Nurse PractitionerMN
Clinical PsychologistGA
Registered Dietitian Or Nutrition ProfessionalMN
P S Y C H I A T R YMN
Clinical PsychologistNY
Nurse PractitionerMN

Reviews

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Frequently asked questions

What unique ID ties claims to DR. TITILOPE OLAOLUWA OMISAKIN (DNP, APRN, CNP)?
NPI 1407536345 is assigned to DR. TITILOPE OLAOLUWA OMISAKIN (DNP, APRN, CNP) under the national enumeration system.
Does this profile mean DR. TITILOPE OLAOLUWA OMISAKIN (DNP, APRN, CNP) is currently active?
Yes — DR. TITILOPE OLAOLUWA OMISAKIN (DNP, APRN, CNP) appears active in the national provider directory.
Can you summarize DR. TITILOPE OLAOLUWA OMISAKIN (DNP, APRN, CNP)'s specialty in plain language?
Clinically, the directory lists DR. TITILOPE OLAOLUWA OMISAKIN (DNP, APRN, CNP) with Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Does DR. TITILOPE OLAOLUWA OMISAKIN (DNP, APRN, CNP) practice in Minnesota?
You will see Blaine, Minnesota on file for DR. TITILOPE OLAOLUWA OMISAKIN (DNP, APRN, CNP) alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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