OMOTAYO OMOSEBI ABDUL PMHNP
NPI 1417623984
Nurse Practitioner - Psychiatric/Mental Health in Atlanta, GA

Q: What is Omotayo Abdul's NPI number?

The NPI number for Omotayo Abdul is 1417623984. It was assigned to this individual provider in the NPPES registry on August 17, 2021.

Q: What is Omotayo Abdul'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 Omotayo Abdul was last updated on January 6, 2026. 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 August 17, 2021PECOS EnrolledAccepts Medicare Assignment

1401 PEACHTREE ST NE STE 110, ATLANTA, GA 30309(470) 749-3520(470) 378-1997 Get Directions Write a Review

NPPES record last updated: January 6, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 6, 2026, Aug 17, 2021 (2 updates tracked since 2021).

On this page

About Omotayo Omosebi Abdul Pmhnp NPPES

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

OMOTAYO OMOSEBI ABDUL PMHNP (NPI 1417623984) is an individual psychiatric/mental health provider in Atlanta, Georgia, licensed in Georgia (APRN-NP114603) and active in the NPI registry since August 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2014).

NPPES Registry Identity

NPI1417623984

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameOMOTAYO OMOSEBI ABDULCredential: PMHNP

Location Address1401 PEACHTREE ST NE STE 110Atlanta, GA 30309-3005

Mailing Address1401 Peachtree St Ne Ste 110Atlanta, GA 30309-3005 · (470) 749-3520 · Fax (470) 378-1997

Phone(470) 749-3520

Fax(470) 378-1997

Sole ProprietorYes

Medical School CMSOtherGraduated 2014

Enumeration DateAugust 17, 2021

Last NPPES UpdateJanuary 6, 20262 updates tracked since enumeration

NPPES CertifiedJanuary 6, 2026

✔ NPI 1417623984 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-NP114603

Also ListedRegistered NurseTaxonomy 163W00000X · License RN114603 (GA)

1401 PEACHTREE ST NE STE 110, Atlanta, GA 30309

Open in Google Maps ↗

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

Omotayo Omosebi Abdul 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 ID749671477

PECOS Enrollment IDI20220106001316

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 Reassignment

Medicare enrollment records show Omotayo Abdul reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Personal Recovery Network LLC

22 mi

Psychiatry

250 CORPORATE CENTER CT
Stockbridge, GA 30281

Reassigned Medicare billing, Georgia enrollment
592 clinicians in this Medicare group

NPI 1881990869 (770) 389-8100

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

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.

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.

54 services11 patients

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.

54 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30309 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.

Other Providers at the Same Location NPPES 10

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

CAROLINE MARIE BOZARTH LPC

Counselor (Professional)