MRS. JUMOKE FADEKE OMISORE NP
NPI 1629558572
Nurse Practitioner - Psychiatric/Mental Health in Gambrills, MD
About Mrs. Jumoke Fadeke Omisore Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. JUMOKE FADEKE OMISORE NP (NPI 1629558572) is an individual psychiatric/mental health provider in Gambrills, Maryland, licensed in Maryland (R147715) and active in the NPI registry since August 2018. She is enrolled in Medicare PECOS, maintains a secondary practice location in Gambrills, and is a graduate of Other (2017).
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Group Practice 1
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
Mrs. Jumoke Fadeke Omisore Np 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.
Medicare Billing Reassignments
5Medicare enrollment records show Jumoke Omisore reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Glen Burnie, MD 21061
- Reassigned Medicare billing, Maryland enrollment
- 10 clinicians in this Medicare group
Dundalk, MD 21222
- Reassigned Medicare billing, Maryland enrollment
- 49 clinicians in this Medicare group
Baltimore, MD 21201
- Reassigned Medicare billing, Maryland enrollment
Windsor Mill, MD 21244
- Reassigned Medicare billing, Maryland enrollment
- 10 clinicians in this Medicare group
Miami, FL 33130
- Reassigned Medicare billing, District of Columbia enrollment
- 1,424 clinicians in this Medicare group
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 21054 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Jumoke Omisore's NPI number?
The NPI number for Jumoke Omisore is 1629558572. It was assigned to this individual provider in the NPPES registry on August 20, 2018.
Where is Jumoke Omisore located?
Jumoke Omisore practices at 1529 Winfields Ln, Gambrills, MD 21054. The listed phone number is (410) 790-9640.
What is Jumoke Omisore's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Jumoke Omisore enrolled in Medicare?
Yes. Jumoke Omisore 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 Jumoke Omisore's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jumoke Omisore reassigns Medicare benefits to 5 organizations: Valor Health Inc (Glen Burnie, MD), Matclinic Physicians Practice Group LLC (Dundalk, MD), Winners Healthcare Services LLC (Baltimore, MD), Bon Ridge Wellness, LLC (Windsor Mill, MD) and Grow Healthcare Group PA (Miami, FL). 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 Jumoke Omisore'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 Jumoke Omisore was last updated on December 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.
# Mrs. Jumoke Fadeke Omisore, NP · NPI 1629558572
Psychiatric/Mental Health physician in Gambrills, Maryland. Individual provider, active in the CMS NPPES registry since August 20, 2018.
## Identity
- **NPI:** 1629558572 (Entity type: Individual)
- **Enumerated:** August 20, 2018
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** R147715 (Maryland)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1529 WINFIELDS LN, Gambrills, MD 21054-1127
- **Phone:** (410) 790-9640
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 5 organizations under Medicare reassignment (form CMS-855R): Valor Health Inc (NPI 1427576040, Glen Burnie, MD); Matclinic Physicians Practice Group LLC (NPI 1104375294, Dundalk, MD); Winners Healthcare Services LLC (NPI 1811596281, Baltimore, MD); Bon Ridge Wellness, LLC (NPI 1922710995, Windsor Mill, MD); Grow Healthcare Group PA (NPI 1245845932, Miami, FL) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2017
## Record status
- **NPPES last updated:** December 13, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1629558572) · Data from the CMS NPPES public registry.