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OLUBUKOLA AWE NP
NPI 1104114149
Nurse Practitioner in Waterbury, CT

Active since July 12, 2011PECOS Enrolled
140 GRANDVIEW AVE STE L01, WATERBURY, CT 06708(203) 574-4187(203) 575-2153 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 17, 2018, Dec 13, 2017 (2 updates tracked since 2017).

About Olubukola Awe Np NPPES

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

OLUBUKOLA AWE NP (NPI 1104114149) is an individual nurse practitioner in Waterbury, Connecticut, licensed in Missouri (2011009356) and active in the NPI registry since July 2011. She is enrolled in Medicare PECOS, maintains a secondary practice location in Independence, and is a graduate of Other (2010).

NPPES Registry Identity

NPI1104114149
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameOLUBUKOLA AWECredential: NP
Location Address140 GRANDVIEW AVE STE L01Waterbury, CT 06708-2500
Mailing Address19201 E Valley View Pkwy, Ste GIndependence, MO 64055-6910 · (816) 254-2552 · Fax (816) 833-4155
Phone(203) 574-4187
Fax(203) 575-2153
Sole ProprietorNo
Medical School CMSOtherGraduated 2010
Enumeration DateJuly 12, 2011
Last NPPES UpdateMarch 17, 20182 updates tracked since enumeration
✔ NPI 1104114149 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in MO · 2011009356
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
140 GRANDVIEW AVE STE L01, Waterbury, CT 06708
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Secondary Practice Location 1

Location 119201 E Valley View Pkwy, Ste GIndependence, MO 64055-6910 · Phone (816) 254-2552 · Fax (816) 833-4155

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Olubukola Awe Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2062687759
PECOS Enrollment IDI20170925000124
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 06708 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
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
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.

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 Olubukola Awe's NPI number?

The NPI number for Olubukola Awe is 1104114149. It was assigned to this individual provider in the NPPES registry on July 12, 2011.

Where is Olubukola Awe located?

Olubukola Awe practices at 140 Grandview Ave Ste L01, Waterbury, CT 06708. The listed phone number is (203) 574-4187.

What is Olubukola Awe's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Olubukola Awe enrolled in Medicare?

Yes. Olubukola Awe is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Olubukola Awe was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.