OMOTADE ADEMOYE (APRN) – Acute Care Nurse Practitioner, NPI 1073222055

OMOTADE ADEMOYE (APRN) is a healthcare provider. based in Tulsa, Oklahoma. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. 210459 (OK). The NPI Number for OMOTADE ADEMOYE (APRN) is 1073222055

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
OMOTADE ADEMOYE (APRN)
NPI
1073222055
Phone
(918) 924-1781
Address
18713 E 42ND PL
Enumeration Date
18 November 2022
Last Update Date
18 November 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9185791000
Graduation Year
2022 (4 years ago)
PAC ID
2567833171
Group Practice PAC ID
7214327832
Professional Enrollment ID
I20230118002007
Address ID
OK741044012TU1120XAVEX405
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

3,299 NURSE PRACTITIONER in OK

Provider Addresses for OMOTADE ADEMOYE (APRN)

  • 18713 E 42ND PL

    TULSA, OK 741345927

    Phone: (918) 924-1781

    Type: Mailing

  • 1120 S UTICA AVE

    TULSA, OK 741044012

    Phone: (918) 579-1000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2023-01-18

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
I20230118002007INurse PractitionerOKTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes285107$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes5423$0
99239Hospital discharge day management, more than 30 minutes4747$0
99238Hospital discharge day management, 30 minutes or less1515$0
View full utilization report →

Insurance plans in this area (ZIP 74134)

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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: 7214327832View full group profile
NameSpecialtyState
Nurse PractitionerOK
Internal MedicinePA
Nurse PractitionerOK
Internal Medicine, Hospice/Palliative CareOK
Nurse PractitionerOK
Physician AssistantOK
Internal MedicineOK
Family PracticeOK
Nurse PractitionerOK
Internal MedicineMO

Reviews

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Frequently asked questions

How do payers reference OMOTADE ADEMOYE (APRN)?
For OMOTADE ADEMOYE (APRN), use NPI 1073222055 as the unique 10-digit identifier.
Is OMOTADE ADEMOYE (APRN) still an active registrant?
OMOTADE ADEMOYE (APRN) carries an active NPI according to the public dataset.
How would a patient describe OMOTADE ADEMOYE (APRN)'s focus?
For OMOTADE ADEMOYE (APRN), the primary taxonomy reads as Acute Care Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What practice footprint exists for OMOTADE ADEMOYE (APRN)?
Travel planning: use Tulsa, Oklahoma as the reference point for OMOTADE ADEMOYE (APRN), then confirm.
Can I trust this NPI listing for OMOTADE ADEMOYE (APRN)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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