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RALIAT OYEBOLA ODEWALE FNP-BC
NPI 1629854146
Nurse Practitioner - Family in Upper Marlboro, MD

Active since September 01, 2023PECOS Enrolled
1400 MERCANTILE LN STE 180, UPPER MARLBORO, MD 20774(443) 231-7240 Get Directions Write a Review

NPPES record last updated: May 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 11, 2025, Sep 1, 2023 (2 updates tracked since 2023).

About Raliat Oyebola Odewale Fnp-bc NPPES

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

RALIAT OYEBOLA ODEWALE FNP-BC (NPI 1629854146) is an individual family provider in Upper Marlboro, Maryland, licensed in Maryland (R231272) and active in the NPI registry since September 2023. She is enrolled in Medicare PECOS and maintains a secondary practice location in Essex.

NPPES Registry Identity

NPI1629854146
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameRALIAT OYEBOLA ODEWALECredential: FNP-BC
Location Address1400 MERCANTILE LN STE 180Upper Marlboro, MD 20774-5369
Mailing Address2404 Heather Stone DrGambrills, MD 21054-1640
Phone(443) 231-7240
Sole ProprietorYes
Enumeration DateSeptember 1, 2023
Last NPPES UpdateMay 11, 20252 updates tracked since enumeration
NPPES CertifiedMay 11, 2025
✔ NPI 1629854146 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 MD · R231272
1400 MERCANTILE LN STE 180, Upper Marlboro, MD 20774
Open in Google Maps ↗

Secondary Practice Location 1

Location 19 Misty Meadows CtEssex, MD 21221-3353 · Phone (443) 231-7240

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Raliat Oyebola Odewale Fnp-bc 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 20774 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
$100.31 typical visit price
range $65.18 – $194.86
Typical copayment $25.07 (range $16.29 – $48.71)
Most-billed visit code 99203
Established Patient
$113.72 typical visit price
range $21.40 – $158.88
Typical copayment $28.43 (range $5.35 – $39.72)
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 3

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

LAKEWOOD HEALTHCARE CENTER
Family Medicine
1400 MERCANTILE LN STE 180
LARGO, MD 20774
Prince George's County (301) 925-7002
DARMON MEDICAL SERVICES
Clinic/Center (Student Health)
1400 MERCANTILE LN STE 180
LARGO, MD 20774
Prince George's County (301) 925-7022
MR. AKINLAWON OLUGBENGA AYENI M.D.
Psychiatry & Neurology (Addiction Medicine)
1400 MERCANTILE LN STE 180
LARGO, MD 20774
Prince George's County (301) 925-7022

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 Raliat Odewale's NPI number?

The NPI number for Raliat Odewale is 1629854146. It was assigned to this individual provider in the NPPES registry on September 1, 2023.

Where is Raliat Odewale located?

Raliat Odewale practices at 1400 Mercantile Ln Ste 180, Upper Marlboro, MD 20774. The listed phone number is (443) 231-7240.

What is Raliat Odewale's specialty?

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

Is Raliat Odewale enrolled in Medicare?

Yes. Raliat Odewale is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Raliat Odewale was last updated on May 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.