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OLAWALE NURUDEEN MOYOSORE
NPI 1063087849
Nurse Practitioner - Psychiatric/Mental Health in Prescott, AZ

Active since May 24, 2021PECOS Enrolled
500 HIGHWAY 89 NORTH, PRESCOTT, AZ 86313(928) 445-4860 Get Directions Write a Review

NPPES record last updated: January 28, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 28, 2022, May 24, 2021 (2 updates tracked since 2021).

About Olawale Nurudeen Moyosore NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OLAWALE NURUDEEN MOYOSORE (NPI 1063087849) is an individual psychiatric/mental health provider in Prescott, Arizona, licensed in Arizona (262277) and active in the NPI registry since May 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1063087849
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameOLAWALE NURUDEEN MOYOSORE
Location Address500 HIGHWAY 89 NORTHPrescott, AZ 86313
Mailing Address181 Whipple StPrescott, AZ 86301-1705 · (480) 719-6554
Phone(928) 445-4860
Sole ProprietorNo
Enumeration DateMay 24, 2021
Last NPPES UpdateJanuary 28, 20222 updates tracked since enumeration
NPPES CertifiedJanuary 28, 2022
✔ NPI 1063087849 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Licenses✔ Licensed in AZ · 262277✔ Licensed in TX · AP143491
500 HIGHWAY 89 NORTH, Prescott, AZ 86313
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Olawale Nurudeen Moyosore is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 86313 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.89 typical visit price
range $55.44 – $168.60
Typical copayment $21.47 (range $13.86 – $42.15)
Most-billed visit code 99203
Established Patient
$98.00 typical visit price
range $17.72 – $137.41
Typical copayment $24.50 (range $4.43 – $34.35)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JENNIFER YEN TU PHARMD
Pharmacist
500 HIGHWAY 89 NORTH
PRESCOTT, AZ 86313
Yavapai County (928) 445-4860
FABIOLA FEIG FNP
Nurse Practitioner (Family)
500 HIGHWAY 89 NORTH
PRESCOTT, AZ 86313
Yavapai County (928) 445-4860
DR. EDWARD ALLEN COLLACOTT M.D
Physical Medicine & Rehabilitation
500 HIGHWAY 89 NORTH
PRESCOTT, AZ 86313
Yavapai County (928) 717-7437
JENNIFER JAULANE COLETTA
Social Worker
500 HIGHWAY 89 NORTH
PRESCOTT, AZ 86313
Yavapai County (928) 445-4860
ALISON LAPHAM RRT
Respiratory Therapist, Registered (Critical Care)
500 HIGHWAY 89 NORTH
PRESCOTT, AZ 86313
Yavapai County (928) 593-9856
MS. KATHLEEN B HARRIS LPN
Licensed Practical Nurse
500 HIGHWAY 89 NORTH, N AZ VA HEALTH CARE SYSTEM
PRESCOTT, AZ 86313
Yavapai County (928) 445-4860
MEGAN LINDSEY GOLDENSTEIN PHARMD
Pharmacist (Pharmacotherapy)
500 HIGHWAY 89 NORTH
PRESCOTT, AZ 86313
Yavapai County (928) 445-4860
MRS. KELLY RAE HANSON PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
500 HIGHWAY 89 NORTH
PRESCOTT, AZ 86313
Yavapai County (928) 445-4860

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Olawale Moyosore's NPI number?

The NPI number for Olawale Moyosore is 1063087849. It was assigned to this individual provider in the NPPES registry on May 24, 2021.

Where is Olawale Moyosore located?

Olawale Moyosore practices at 500 Highway 89 North, Prescott, AZ 86313. The listed phone number is (928) 445-4860.

What is Olawale Moyosore's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Olawale Moyosore enrolled in Medicare?

Yes. Olawale Moyosore is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Olawale Moyosore was last updated on January 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.