OMOTADE OYEBANJI (PMHNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1710781042

OMOTADE OYEBANJI (PMHNP) is a healthcare provider. based in Odessa, Texas. specializing in NURSE PRACTITIONER. They hold the professional credentials PMHNP. They hold a License No. 1194523 (TX). The NPI Number for OMOTADE OYEBANJI (PMHNP) is 1710781042

Main info

Female
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
OMOTADE OYEBANJI (PMHNP)
NPI
1710781042
Phone
(832) 818-2154
Address
1016 INDIGO CT
Enumeration Date
3 April 2025
Last Update Date
3 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4325615915
Graduation Year
2024 (2 years ago)
PAC ID
0840798914
Group Practice PAC ID
6901029206
Professional Enrollment ID
I20250807004552
Address ID
TX797062601MI3300XFMXX303
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

22,204 NURSE PRACTITIONER in TX

Provider Addresses for OMOTADE OYEBANJI (PMHNP)

  • 1016 INDIGO CT

    ODESSA, TX 797652511

    Phone: (832) 818-2154

    Type: Mailing

  • 3300 S FM 1788

    MIDLAND, TX 797062601

    Phone: (432) 561-5915

    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: 2025-08-07

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
I20250807004552INurse PractitionerTXTBD

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 79765)

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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: 6901029206View full group profile
NameSpecialtyState
P S Y C H I A T R YSC
Nurse PractitionerTX
Nurse PractitionerTX
Nurse PractitionerTX
Nurse PractitionerTX
-TX
P S Y C H I A T R YTX
Nurse PractitionerTX
P S Y C H I A T R YTX
Nurse PractitionerTX

Reviews

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Frequently asked questions

How do I look up OMOTADE OYEBANJI (PMHNP) by NPI?
Use NPI 1710781042 when you need to reference OMOTADE OYEBANJI (PMHNP) in forms, claims, or directories.
Is OMOTADE OYEBANJI (PMHNP) active in the national directory?
OMOTADE OYEBANJI (PMHNP)'s public NPI profile is in an active state.
What does OMOTADE OYEBANJI (PMHNP) treat or focus on?
Patients typically see OMOTADE OYEBANJI (PMHNP) under the specialty Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where does public data place OMOTADE OYEBANJI (PMHNP)?
The snapshot lists Odessa, Texas for OMOTADE OYEBANJI (PMHNP); download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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