OLUBODUN AJIBAYO OFAKUNRIN PMHNP, CNP
NPI 1790657633
Nurse Practitioner - Psychiatric/Mental Health in New Brighton, MN

Q: What is Olubodun Ofakunrin's NPI number?

The NPI number for Olubodun Ofakunrin is 1790657633. It was assigned to this individual provider in the NPPES registry on September 20, 2025.

Q: What is Olubodun Ofakunrin's specialty?

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

Active since September 20, 2025PECOS EnrolledAccepts Medicare Assignment

1900 SILVER LAKE RD NW STE 110, NEW BRIGHTON, MN 55112(651) 628-9566(651) 628-0411 Get Directions Write a Review

NPPES record last updated: December 11, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 11, 2025, Sep 20, 2025 (2 updates tracked since 2025).

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About Olubodun Ajibayo Ofakunrin Pmhnp, Cnp NPPES

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

OLUBODUN AJIBAYO OFAKUNRIN PMHNP, CNP (NPI 1790657633) is an individual psychiatric/mental health provider in New Brighton, Minnesota, licensed in Minnesota (13390) and active in the NPI registry since September 2025. He is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1790657633

Entity TypeIndividualMale

Primary Taxonomy363LP0808X

Provider Legal NameOLUBODUN AJIBAYO OFAKUNRINCredential: PMHNP, CNP

Location Address1900 SILVER LAKE RD NW STE 110New Brighton, MN 55112-1789

Mailing Address1811 Weir Dr Ste 270Woodbury, MN 55125-6741 · (651) 714-9646 · Fax (651) 714-9647

Phone(651) 628-9566

Fax(651) 628-0411

Sole ProprietorYes

Medical School CMSOtherGraduated 2025

Enumeration DateSeptember 20, 2025

Last NPPES UpdateDecember 11, 20252 updates tracked since enumeration

NPPES CertifiedDecember 11, 2025

✔ NPI 1790657633 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 MN · 13390

1900 SILVER LAKE RD NW STE 110, New Brighton, MN 55112

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, Sanford Health Plan.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

Olubodun Ajibayo Ofakunrin Pmhnp, Cnp 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 ID3173014800

PECOS Enrollment IDI20251111001792

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 Olubodun Ofakunrin reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Nystrom & Associates, Ltd

Same address

Clinical

1900 SILVER LAKE RD NW, SUITE 110
New Brighton, MN 55112

Reassigned Medicare billing, Minnesota enrollment
794 clinicians in this Medicare group

NPI 1396750188 (651) 628-9566

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 55112 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

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$98.61 typical visit price

range $18.32 – $138.04

Typical copayment $24.65 (range $4.58 – $34.51)

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 20

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

DAVID HAWKINSON

Counselor (Mental Health)