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: January 15, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 15, 2026, Aug 5, 2020, Jul 14, 2020 (3 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
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateJuly 14, 2020
Last NPPES UpdateJanuary 15, 20263 updates tracked since enumeration
NPPES CertifiedJanuary 15, 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

Accepted Insurance

Medicare Participation & PECOS CMS

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

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.

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.

Psychiatry & Neurology (Psychiatry)
3345 N WINDSONG DR
PRESCOTT VALLEY, AZ 86314
Registered Nurse (Psychiatric/Mental Health)
3345 N WINDSONG DR
PRESCOTT VALLEY, AZ 86314
Nurse Practitioner (Family)
3345 N WINDSONG DR
PRESCOTT VALLEY, AZ 86314
Social Worker (Clinical)
3345 N WINDSONG DR
PRESCOTT VALLEY, AZ 86314
Registered Nurse (Psychiatric/Mental Health)
3345 N WINDSONG DR
PRESCOTT VALLEY, AZ 86314
Counselor (Professional)
3345 N WINDSONG DR
PRESCOTT VALLEY, AZ 86314
Psychiatry & Neurology (Psychiatry)
3345 N WINDSONG DR
PRESCOTT VALLEY, AZ 86314
Clinic/Center (Primary Care)
3345 N WINDSONG DR, ATTN: TINA TOLLIVER, SUITE B
PRESCOTT VALLEY, AZ 86314

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.

What insurance does Ibukun Odutola accept?

Health plans from Anthem Blue Cross and Blue Sheld, Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of Arizona, Oscar Health Plan, Inc. and Providence Health Plan 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 January 15, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.