OMONIYI FATAI MUTIU PMHNP
NPI 1396247359
Nurse Practitioner - Psychiatric/Mental Health in Duluth, GA

Q: What is Omoniyi Mutiu's NPI number?

The NPI number for Omoniyi Mutiu is 1396247359. It was assigned to this individual provider in the NPPES registry on March 6, 2018.

Q: What is Omoniyi Mutiu's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Omoniyi Mutiu was last updated on October 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.

Active since March 06, 2018PECOS EnrolledAccepts Medicare Assignment

2055 SUGARLOAF CIR STE 575, DULUTH, GA 30097(404) 999-7971 Get Directions Write a Review

NPPES record last updated: October 23, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 5, 2024, Oct 8, 2018, Mar 6, 2018 (3 updates tracked since 2018).

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About Omoniyi Fatai Mutiu Pmhnp NPPES

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

OMONIYI FATAI MUTIU PMHNP (NPI 1396247359) is an individual psychiatric/mental health provider in Duluth, Georgia, licensed in Georgia (APRN-NP286020) and active in the NPI registry since March 2018. He is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1396247359

Entity TypeIndividualMale

Primary Taxonomy363LP0808X

Provider Legal NameOMONIYI FATAI MUTIUCredential: PMHNP

Location Address2055 SUGARLOAF CIR STE 575Duluth, GA 30097-9804

Mailing Address2055 Sugarloaf Cir Ste 575Duluth, GA 30097-9804 · (404) 999-7971 · Fax (678) 534-2045

Phone(404) 999-7971

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateMarch 6, 2018

Last NPPES UpdateOctober 23, 20253 updates tracked since enumeration

NPPES CertifiedOctober 23, 2025

✔ NPI 1396247359 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in GA · APRN-NP286020

Also ListedRegistered NurseTaxonomy 163W00000X · License RN286020 (GA)

2055 SUGARLOAF CIR STE 575, Duluth, GA 30097

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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 and accepts Medicare assignment

Omoniyi Fatai Mutiu Pmhnp 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 ID8022369776

PECOS Enrollment IDI20200323002145

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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

70 services22 patients

Psychotherapy with evaluation and management visit, 30 minutes 90833

Psychotherapy with evaluation and management is a 30-minute session where a mental health professional talks with you about your concerns and feelings. They assess your mental health, provide support, and manage your treatment plan to help improve your well-being.

18 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30097 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

$88.06 typical visit price

range $56.84 – $172.43

Typical copayment $22.01 (range $14.21 – $43.10)

Most-billed visit code 99203

Established Patient

$100.20 typical visit price

range $18.22 – $140.40

Typical copayment $25.05 (range $4.55 – $35.10)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

100%25 patients5/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 9

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

WILLIAM G MCLEOD LPC, NCAC-II

Counselor (Professional)