Iconichealth LLC
NPI 1972106292ActiveOrganization· Nurse Practitioner, Psych/Mental Health· Ewing, NJ
Nurse Practitioner, Psych/Mental Health in Ewing, New Jersey, registered in NPPES in November 2020. The authorized official on file is Olasumbo Joseph Oladeru, NURSE PRACTITIONER, Chief Operating Officer. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1972106292 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 19, 2020 |
| Last updated in NPPES | Jan 28, 2026 |
| Certified by provider | Jan 28, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Psych/Mental Health Primary | 363LP0808X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NJ) |
|---|
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