1. Home
  2. Directory
  3. California
  4. Patton
  5. Psychiatry Neurology
  6. NPI Profile

DR. BOLANLE O OLUWADARA M.D.
NPI 1124250188
Psychiatry & Neurology - Psychiatry in Patton, CA

Active since August 10, 2009PECOS EnrolledAccepts Medicare Assignment
3102 E. HIGHLAND AVENUE, MEDICAL STAFF OFFICE, PATTON, CA 92369(909) 425-7000 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 21, 2022, Aug 2, 2017, Jul 25, 2017 (3 updates tracked since 2017).

About Dr. Bolanle O Oluwadara M.d. NPPES

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

DR. BOLANLE O OLUWADARA M.D. (NPI 1124250188) is an individual psychiatry provider in Patton, California, licensed in California (A146902) and active in the NPI registry since August 2009. She is enrolled in Medicare PECOS and is a graduate of Other (1998).

NPPES Registry Identity

NPI1124250188
Entity TypeIndividualFemale
Primary Taxonomy2084P0800X
Provider Legal NameDR. BOLANLE O OLUWADARACredential: M.D.
Location Address3102 E. HIGHLAND AVENUE, MEDICAL STAFF OFFICEPatton, CA 92369
Mailing Address3102 E. Highland AvenuePatton, CA 92369 · (909) 425-7000
Phone(909) 425-7000
Sole ProprietorYes
Medical School CMSOtherGraduated 1998
Enumeration DateAugust 10, 2009
Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration
✔ NPI 1124250188 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in CA · A146902
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
3102 E. HIGHLAND AVENUE, Patton, CA 92369
Open in Google Maps ↗

Other Names 1

Former Name (1)Dr. Bolanle Oluwakemi Adeniji Md

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Bolanle O Oluwadara M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4183926900
PECOS Enrollment IDI20170928002823
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Bolanle Oluwadara reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Department Of State Hospitals
Same address
Psychiatric Hospital
3102 E HIGHLAND AVE
Patton, CA 92369
  • Reassigned Medicare billing, California enrollment
  • 755 clinicians in this Medicare group
NPI 1043249204 (909) 425-7552
Diligence Care Plus Nursing Corporation
91 mi
Psychiatric/Mental Health
1233 N E ST
San Bernardino, CA 92405
  • Reassigned Medicare billing, California enrollment
  • 6 clinicians in this Medicare group
NPI 1548977242 (951) 318-5396

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92369 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
$179.42 typical visit price
range $59.60 – $179.42
Typical copayment $44.85 (range $14.90 – $44.85)
Most-billed visit code 99205
Established Patient
$74.08 typical visit price
range $19.37 – $146.42
Typical copayment $18.52 (range $4.84 – $36.60)
Most-billed visit code 99213
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 20

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

LEIGH A LINDSEY M.D.
Psychiatry & Neurology (Psychiatry)
3102 E. HIGHLAND AVENUE, MEDICAL STAFF OFFICE
PATTON, CA 92369
San Bernardino County (909) 425-7679
KENNY CHAN WIN M.D.
Internal Medicine
3102 E. HIGHLAND AVENUE, MEDICAL STAFF OFFICE
PATTON, CA 92369
San Bernardino County (909) 425-7679
NASHIRA YVETTE FUNN LCSW
Social Worker (Clinical)
3102 E. HIGHLAND AVENUE, MEDICAL STAFF OFFICE
PATTON, CA 92369
San Bernardino County (909) 425-7000
DEBRA F JOHNSON LCSW
Social Worker (Clinical)
3102 E. HIGHLAND AVENUE, MEDICAL STAFF OFFICE
PATTON, CA 92369
San Bernardino County (909) 425-7000
MARIANITA ARALAR RAYMUNDO M.D.
Family Medicine
3102 E. HIGHLAND AVENUE, MEDICAL STAFF OFFICE
PATTON, CA 92369
San Bernardino County (909) 425-7000
DR. YVONNE CARROL MCDOWELL M.D.
Psychiatry & Neurology (Psychiatry)
3102 E. HIGHLAND AVENUE, MEDICAL STAFF OFFICE
PATTON, CA 92369
San Bernardino County (909) 425-7679
MR. ROGER JOHN CABANSAG M.D.
Psychiatry & Neurology (Psychiatry)
3102 E. HIGHLAND AVENUE, MEDICAL STAFF OFFICE
PATTON, CA 92369
San Bernardino County (909) 425-7679
KRISTINE I VINDUA PSY.D.
Psychologist (Clinical)
3102 E. HIGHLAND AVENUE, PATTON STATE HOSPITAL
PATTON, CA 92369
San Bernardino County (909) 425-7679

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 Bolanle Oluwadara's NPI number?

The NPI number for Bolanle Oluwadara is 1124250188. It was assigned to this individual provider in the NPPES registry on August 10, 2009. The provider is also known as Dr. Bolanle Oluwakemi Adeniji MD.

Where is Bolanle Oluwadara located?

Bolanle Oluwadara practices at 3102 E. Highland Avenue Medical Staff Office, Patton, CA 92369. The listed phone number is (909) 425-7000.

What is Bolanle Oluwadara's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Bolanle Oluwadara enrolled in Medicare?

Yes. Bolanle Oluwadara is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Bolanle Oluwadara's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Bolanle Oluwadara reassigns Medicare benefits to 2 organizations: Department Of State Hospitals (Patton, CA) and Diligence Care Plus Nursing Corporation (San Bernardino, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Bolanle Oluwadara's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Bolanle Oluwadara was last updated on July 21, 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.