SHIYANBOLA AJAO
NPI 1790363653
Nurse Practitioner - Psychiatric/Mental Health in Union, NJ
About Shiyanbola Ajao NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHIYANBOLA AJAO (NPI 1790363653) is an individual psychiatric/mental health provider in Union, New Jersey, licensed in New Jersey (26NJ14933300) and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS, maintains a secondary practice location in Atlanta, and is a graduate of Other (2021).
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Accepted Insurance
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
Shiyanbola Ajao 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
2Medicare enrollment records show Shiyanbola Ajao reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Atlanta, GA 30303
- Reassigned Medicare billing, Georgia enrollment
- 771 clinicians in this Medicare group
Miami, FL 33130
- Reassigned Medicare billing, Washington enrollment
- 519 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 07083 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 Shiyanbola Ajao's NPI number?
The NPI number for Shiyanbola Ajao is 1790363653. It was assigned to this individual provider in the NPPES registry on March 31, 2021.
Where is Shiyanbola Ajao located?
Shiyanbola Ajao practices at 540 North Ave # 2036, Union, NJ 07083. The listed phone number is (912) 844-3313.
What is Shiyanbola Ajao's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Shiyanbola Ajao enrolled in Medicare?
Yes. Shiyanbola Ajao 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 Shiyanbola Ajao's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Shiyanbola Ajao reassigns Medicare benefits to 2 organizations: Grady Memorial Hospital Corporation (Atlanta, GA) 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 Shiyanbola Ajao's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Shiyanbola Ajao accept?
Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., Premera Blue Cross Blue Shield of Alaska, Regence BlueCross BlueShield of Oregon and UnitedHealthcare list Shiyanbola Ajao as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Shiyanbola Ajao was last updated on November 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.
# Shiyanbola Ajao · NPI 1790363653
Psychiatric/Mental Health physician in Union, New Jersey. Individual provider, active in the CMS NPPES registry since March 31, 2021.
## Identity
- **NPI:** 1790363653 (Entity type: Individual)
- **Enumerated:** March 31, 2021
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** 26NJ14933300 (New Jersey)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 540 NORTH AVE # 2036, Union, NJ 07083-7148
- **Phone:** (912) 844-3313
## 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:** 2 organizations under Medicare reassignment (form CMS-855R): Grady Memorial Hospital Corporation (NPI 1114243813, Atlanta, GA); Grow Healthcare Group PA (NPI 1245845932, Miami, FL) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** November 28, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1790363653) · Data from the CMS NPPES public registry.