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DR. MUTIAT AYOBAMIDELE OLUKOGA FNP
NPI 1902613417
Nurse Practitioner - Family in Cottage Grove, MN

Active since December 17, 2024PECOS Enrolled
6805 CATTAIL CT S, COTTAGE GROVE, MN 55016(651) 239-0617 Get Directions Write a Review

NPPES record last updated: December 17, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Mutiat Ayobamidele Olukoga Fnp NPPES

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

DR. MUTIAT AYOBAMIDELE OLUKOGA FNP (NPI 1902613417) is an individual family provider in Cottage Grove, Minnesota, licensed in Minnesota (12357) and active in the NPI registry since December 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1902613417
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameDR. MUTIAT AYOBAMIDELE OLUKOGACredential: FNP
Location Address6805 CATTAIL CT SCottage Grove, MN 55016-1722
Mailing Address6805 Cattail Ct SCottage Grove, MN 55016-1722 · (651) 239-0617
Phone(651) 239-0617
Sole ProprietorYes
Enumeration DateDecember 17, 2024
NPPES CertifiedDecember 17, 2024
✔ NPI 1902613417 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 MN · 12357
6805 CATTAIL CT S, Cottage Grove, MN 55016
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mutiat Ayobamidele Olukoga Fnp 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.

Medicare Billing Reassignment

Medicare enrollment records show Mutiat Olukoga reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Theoria Medical
504 mi
Internal Medicine
41800 W 11 MILE RD STE 109
Novi, MI 48375
  • Reassigned Medicare billing, Minnesota enrollment
  • 21 clinicians in this Medicare group
NPI 1609362375 (248) 860-4634

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 55016 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.

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 Mutiat Olukoga's NPI number?

The NPI number for Mutiat Olukoga is 1902613417. It was assigned to this individual provider in the NPPES registry on December 17, 2024.

Where is Mutiat Olukoga located?

Mutiat Olukoga practices at 6805 Cattail Ct S, Cottage Grove, MN 55016. The listed phone number is (651) 239-0617.

What is Mutiat Olukoga's specialty?

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

Is Mutiat Olukoga enrolled in Medicare?

Yes. Mutiat Olukoga is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mutiat Olukoga's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mutiat Olukoga reassigns Medicare benefits to Theoria Medical (Novi, MI). The 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 Mutiat Olukoga's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mutiat Olukoga was last updated on December 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.