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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

IBUKUN ODUTOLA
NPI 1801404074
Nurse Practitioner - Psychiatric/Mental Health in Prescott Valley, AZ

Active since July 14, 2020PECOS EnrolledAccepts Medicare Assignment
3345 N WINDSONG DR, PRESCOTT VALLEY, AZ 86314(928) 445-5211 Get Directions Write a Review

NPPES record last updated: September 1, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 1, 2026, Jan 15, 2026, Aug 5, 2020 and 1 more (4 updates tracked since 2020).

About Ibukun Odutola NPPES

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

IBUKUN ODUTOLA (NPI 1801404074) is an individual psychiatric/mental health provider in Prescott Valley, Arizona, licensed in Nevada (810773) and active in the NPI registry since July 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1801404074
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameIBUKUN ODUTOLA
Location Address3345 N WINDSONG DRPrescott Valley, AZ 86314-2283
Mailing Address3345 N Windsong DrPrescott Valley, AZ 86314-2283 · (928) 445-5211
Phone(928) 445-5211
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateJuly 14, 2020
Last NPPES UpdateSeptember 1, 20264 updates tracked since enumeration
NPPES CertifiedSeptember 1, 2026
✔ NPI 1801404074 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
Licenses✔ Licensed in NV · 810773✔ Licensed in AZ · 244759
3345 N WINDSONG DR, Prescott Valley, AZ 86314
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health, Blue Cross Blue Shield of Arizona and more.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

Ibukun Odutola 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 ID3971929704
PECOS Enrollment IDI20201203001816
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

6

Medicare enrollment records show Ibukun Odutola reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

West Yavapai Guidance Clinic, Inc.
Same address
Clinic/Center
3345 N WINDSONG DR
Prescott Valley, AZ 86314
  • Reassigned Medicare billing, Arizona enrollment
  • 24 clinicians in this Medicare group
NPI 1417901943 (928) 445-5211
Victory Health Solution LLC
88 mi
Psychiatric/Mental Health
1136 E HARMONY AVE # 202B-2
Mesa, AZ 85204
  • Reassigned Medicare billing, Arizona and Nevada enrollments
  • 2 clinicians in this Medicare group
NPI 1912515305 (602) 502-4872
I Am Wellness Az LLC
91 mi
Adult Medicine
604 W WARNER RD STE E201
Chandler, AZ 85225
  • Reassigned Medicare billing, Arizona enrollment
  • 62 clinicians in this Medicare group
NPI 1184354532 (601) 324-0793
Albion Medical Group Of Nevada, PC
199 mi
Internal Medicine
3150 N TENAYA WAY STE A
Las Vegas, NV 89128
  • Reassigned Medicare billing, Nevada enrollment
  • 53 clinicians in this Medicare group
NPI 1578840724 (702) 869-9200
Albion Medical Partners Of California West P C
332 mi
Internal Medicine
12900 PARK PLAZA DR, STE 700, MS-7110
Cerritos, CA 90703
  • Reassigned Medicare billing, California enrollment
  • 235 clinicians in this Medicare group
NPI 1073110607 (562) 622-2800
Sud Specialty Group - Ca
574 mi
Addiction Medicine
4633 OLD IRONSIDES DR STE 304
Santa Clara, CA 95054
  • Reassigned Medicare billing, California enrollment
  • 1,607 clinicians in this Medicare group
NPI 1972138238 (323) 205-7088

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 86314 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
$85.89 typical visit price
range $55.44 – $168.60
Typical copayment $21.47 (range $13.86 – $42.15)
Most-billed visit code 99203
Established Patient
$98.00 typical visit price
range $17.72 – $137.41
Typical copayment $24.50 (range $4.43 – $34.35)
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.

BARRY COE M.D.
Psychiatry & Neurology (Psychiatry)
3345 N WINDSONG DR
PRESCOTT VALLEY, AZ 86314
Yavapai County (928) 445-5211
LISA RUBENBAUER RN
Registered Nurse (Psychiatric/Mental Health)
3345 N WINDSONG DR
PRESCOTT VALLEY, AZ 86314
Yavapai County (928) 445-5211
AMY M THEIN FNP
Nurse Practitioner (Family)
3345 N WINDSONG DR
PRESCOTT VALLEY, AZ 86314
Yavapai County (928) 445-5211
ALISON A. STAMBAUGH LMSW
Social Worker (Clinical)
3345 N WINDSONG DR
PRESCOTT VALLEY, AZ 86314
Yavapai County (928) 445-5211
BETH ANN STEVESON RN
Registered Nurse (Psychiatric/Mental Health)
3345 N WINDSONG DR
PRESCOTT VALLEY, AZ 86314
Yavapai County (928) 445-5211
KENT MATTERN LPC
Counselor (Professional)
3345 N WINDSONG DR
PRESCOTT VALLEY, AZ 86314
Yavapai County (928) 445-5211
DR. LISA MARIE PARSONS M.D.
Psychiatry & Neurology (Psychiatry)
3345 N WINDSONG DR
PRESCOTT VALLEY, AZ 86314
Yavapai County (602) 228-9503
WEST YAVAPAI GUIDANCE CLINIC, INC.
Clinic/Center (Primary Care)
3345 N WINDSONG DR, ATTN: TINA TOLLIVER, SUITE B
PRESCOTT VALLEY, AZ 86314
Yavapai County (928) 583-6411

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 Ibukun Odutola's NPI number?

The NPI number for Ibukun Odutola is 1801404074. It was assigned to this individual provider in the NPPES registry on July 14, 2020.

Where is Ibukun Odutola located?

Ibukun Odutola practices at 3345 N Windsong Dr, Prescott Valley, AZ 86314. The listed phone number is (928) 445-5211.

What is Ibukun Odutola's specialty?

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

Is Ibukun Odutola enrolled in Medicare?

Yes. Ibukun Odutola 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 Ibukun Odutola's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ibukun Odutola reassigns Medicare benefits to 6 organizations: West Yavapai Guidance Clinic, Inc. (Prescott Valley, AZ), Victory Health Solution LLC (Mesa, AZ), I Am Wellness Az LLC (Chandler, AZ), Albion Medical Group Of Nevada, PC (Las Vegas, NV), Albion Medical Partners Of California West P C (Cerritos, CA) and 1 more organization, listed in the Medicare section above. 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 Ibukun Odutola's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ibukun Odutola accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona, Cigna HealthCare of Arizona, Inc and Oscar Health Plan, Inc. and 1 other insurer list Ibukun Odutola 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 Ibukun Odutola was last updated on September 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 53 days 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.