DR. BANTALE OLUREMI AYISIRE
NPI 1538969282
Nurse Practitioner - Psychiatric/Mental Health in Winnetka, CA

Q: What is Bantale Ayisire's NPI number?

The NPI number for Bantale Ayisire is 1538969282. It was assigned to this individual provider in the NPPES registry on March 13, 2025.

Q: What is Bantale Ayisire'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 Bantale Ayisire was last updated on March 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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 13, 2025PECOS EnrolledAccepts Medicare Assignment

20623 GREEN ASH LN, WINNETKA, CA 91306(253) 300-1864(818) 303-3331 Get Directions Write a Review

NPPES record last updated: March 25, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 25, 2026, Mar 13, 2025 (2 updates tracked since 2025).

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About Dr. Bantale Oluremi Ayisire NPPES

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

DR. BANTALE OLUREMI AYISIRE (NPI 1538969282) is an individual psychiatric/mental health provider in Winnetka, California, licensed in California (95033816) and active in the NPI registry since March 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1538969282

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameDR. BANTALE OLUREMI AYISIRE

Location Address20623 GREEN ASH LNWinnetka, CA 91306-1557

Mailing Address20623 Green Ash LnWinnetka, CA 91306-1557 · (253) 300-1864 · Fax (818) 303-3331

Phone(253) 300-1864

Fax(818) 303-3331

Sole ProprietorYes

Medical School CMSOtherGraduated 2024

Enumeration DateMarch 13, 2025

Last NPPES UpdateMarch 25, 20262 updates tracked since enumeration

NPPES CertifiedMarch 25, 2026

✔ NPI 1538969282 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

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

Taxonomy Code363LP0808X

License✔ Licensed in CA · 95033816

20623 GREEN ASH LN, Winnetka, CA 91306

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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. Bantale Oluremi Ayisire 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 ID4880170406

PECOS Enrollment IDI20260113002331

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

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

Elty Minds & Research Solutions Group PC

Same address

Psychiatric/Mental Health

20623 GREEN ASH LN
Winnetka, CA 91306

Reassigned Medicare billing, California enrollment

NPI 1548130115 (323) 412-9966

Grow Healthcare Group PC

284 mi

Mental Health

99 S ALMADEN BLVD STE 600
San Jose, CA 95113

Reassigned Medicare billing, California enrollment
3,139 clinicians in this Medicare group

NPI 1154994846 (408) 402-4385

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 91306 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

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

ELTY MINDS & RESEARCH SOLUTIONS GROUP PC

Nurse Practitioner (Psychiatric/Mental Health)

20623 GREEN ASH LN
WINNETKA, CA 91306

Los Angeles County (323) 412-9966

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 Bantale Ayisire's NPI number?

The NPI number for Bantale Ayisire is 1538969282. It was assigned to this individual provider in the NPPES registry on March 13, 2025.

Where is Bantale Ayisire located?

Bantale Ayisire practices at 20623 Green Ash Ln, Winnetka, CA 91306. The listed phone number is (253) 300-1864.

What is Bantale Ayisire's specialty?

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

Is Bantale Ayisire enrolled in Medicare?

Yes. Bantale Ayisire 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 Bantale Ayisire's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Bantale Ayisire reassigns Medicare benefits to 2 organizations: Elty Minds & Research Solutions Group PC (Winnetka, CA) and Grow Healthcare Group PC (San Jose, 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 Bantale Ayisire'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 Bantale Ayisire was last updated on March 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.