MARYJANE DUROMOLA
NPI 1235986647
Nurse Practitioner - Family in Long Beach, CA

Q: What is Maryjane Duromola's NPI number?

The NPI number for Maryjane Duromola is 1235986647. It was assigned to this individual provider in the NPPES registry on May 2, 2024. The provider is also known as Abosede Mary Raji.

Q: What is Maryjane Duromola's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Maryjane Duromola was last updated on June 16, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since May 02, 2024PECOS Enrolled

200 OCEANGATE STE 100, LONG BEACH, CA 90802(909) 361-9913 Get Directions Write a Review

NPPES record last updated: June 16, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 16, 2024, May 2, 2024 (2 updates tracked since 2024).

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About Maryjane Duromola NPPES

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

MARYJANE DUROMOLA (NPI 1235986647) is an individual family provider in Long Beach, California, licensed in California (95029802) and active in the NPI registry since May 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1235986647

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMARYJANE DUROMOLA

Location Address200 OCEANGATE STE 100Long Beach, CA 90802-4317

Mailing Address2605 E Date Palm Paseo Apt 2226Ontario, CA 91764-4672 · (626) 479-6482

Phone(909) 361-9913

Sole ProprietorYes

Enumeration DateMay 2, 2024

Last NPPES UpdateJune 16, 20242 updates tracked since enumeration

NPPES CertifiedJune 16, 2024

✔ NPI 1235986647 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in CA · 95029802

200 OCEANGATE STE 100, Long Beach, CA 90802

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Other Names 1

Former Name (1)Abosede Mary Raji

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Maryjane Duromola 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 90802 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

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

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 20

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

MARY MARTHA MOLINA M.D.

Family Medicine