Mr Anthony Vincent Olorunsola, PMHNP-BC in Tempe, AZ

Mr Anthony Vincent Olorunsola, PMHNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Tempe, Arizona. His current practice location is 4525 S Lakeshore Dr, Tempe, Arizona. You can reach out to his office (for appointments etc.) via phone at (623) 806-6864.

Mr Anthony Vincent Olorunsola is licensed to practice in Arizona (license number AP7477) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1205211802.

Contact Information

	Mr Anthony Vincent Olorunsola, PMHNP-BC
	4525 S Lakeshore Dr, Tempe, AZ 85282-8339
	(623) 806-6864
	Not Available

Map and Direction

Provider's Profile

Full Name	Mr Anthony Vincent Olorunsola
Gender	Male
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	4525 S Lakeshore Dr, Tempe, Arizona
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1205211802
Provider Enumeration Date: 07/23/2015
Last Update Date: 01/16/2023

Medicare PECOS Information:

PECOS PAC ID: 0446569537
Enrollment ID: I20151009002392

Medical Identifiers

Medical identifiers for Mr Anthony Vincent Olorunsola such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1205211802	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	AP7477 (Arizona)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	AP7477 (Arizona)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Anthony Vincent Olorunsola allows following entities to bill medicare on his behalf.

Entity Name	Little Sanctuary Health Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1326683376 PECOS PAC ID: 9537594221 Enrollment ID: O20200128001059

Entity Name	Clear Mind Mental Health Services Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1265293476 PECOS PAC ID: 0244676955 Enrollment ID: O20240315001247

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Anthony Vincent Olorunsola is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Anthony Vincent Olorunsola, PMHNP-BC 11211 E Sonrisa Ave, Mesa, AZ 85212-7079 Ph: (623) 806-6864	Mr Anthony Vincent Olorunsola, PMHNP-BC 4525 S Lakeshore Dr, Tempe, AZ 85282-8339 Ph: (623) 806-6864

Reviews and Comments

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Mr Anthony Vincent Olorunsola, PMHNP-BC - Medicare Nurse Practitioner in Tempe, AZ