Samuel Omolade, APRN PMHNP
Samuel Omolade, APRN PMHNP is a Psychiatric/Mental Health Nurse Practitioner in Dallas, TX, registered under NPI 1548799141. This provider registers 4 separate taxonomy codes, which usually means they practise across more than one recognised specialty. NPPES records them as a sole proprietor, meaning the practice is not incorporated as a separate legal entity.
Getting there
The practice address on file is 11650 MCCREE RD, Dallas, TX 75238. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 1099855 | TX | Psychiatric/Mental Health Nurse… primary |
| 320878-1 | NY | Licensed Practical Nurse |
| 958104 | TX | Administrator Registered Nurse |
| 958104 | TX | Case Manager/Care Coordinator |
| AP61366158 | WA | Psychiatric/Mental Health Nurse… |
Licences are recorded in 3 states: TX, NY, WA. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.
- Status
- Approved
- Provider type
- Practitioner - Nurse Practitioner
- PAC ID
- 3577938281
Enrolled in Medicare 8 times, across 8 states:
| State | Enrollment ID | Provider type |
|---|---|---|
| Texas | I20230412000086 | Practitioner - Nurse Practitioner |
| New York | I20250115003392 | Practitioner - Nurse Practitioner |
| District of Columbia | I20250116003957 | Practitioner - Nurse Practitioner |
| Colorado | I20250117003239 | Practitioner - Nurse Practitioner |
| Iowa | I20250203003275 | Practitioner - Nurse Practitioner |
| New Hampshire | I20250205002748 | Practitioner - Nurse Practitioner |
| Washington | I20250425001120 | Practitioner - Nurse Practitioner |
| New Mexico | I20251208003680 | Practitioner - Nurse Practitioner |
Medicare enrolment is recorded as approved under the provider type Practitioner - Nurse Practitioner. There are 8 separate enrolment records across 8 states (TX, NY, DC, CO, IA, NH, WA, NM). Multiple enrolments usually mean the provider bills Medicare from more than one practice location, or has kept an earlier enrolment after moving. Each record carries its own enrolment ID, listed above. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
Licensed in 3 states
This provider holds licences in 3 states: New York, Texas and Washington. The practice address on file is in Dallas, TX, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.
- Licence
- 1099855
- Specialty
- Psychiatric/Mental Health Nurse…
- Licence
- AP61366158
- Specialty
- Psychiatric/Mental Health Nurse…
Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.
What Psychiatric/Mental Health covers
Definition to come... NUCC Health Care Provider Taxonomy, code 363LP0808X
All registered taxonomy codes
This provider registers 5 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner Psychiatric/Mental Health | 1099855 | TX | primary |
| 164W00000X | Licensed Practical Nurse | 320878-1 | NY | |
| 163WA2000X | Administrator Registered Nurse Administrator | 958104 | TX | |
| 171M00000X | Case Manager/Care Coordinator | 958104 | TX | |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner Psychiatric/Mental Health | AP61366158 | WA |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1548799141 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Jun 7, 2017 |
| Last updated | Jul 15, 2023 |
| Status | Active |
| Sole proprietor | Yes |
| Credential | APRN PMHNP |
| Practice address |
11650 MCCREE RD Dallas, TX 75238 (718) 304-4906 |
| Mailing address |
11650 MCCREE RD APT 2034 Dallas, TX 75238 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 5 | 4 | 8 | 7 | 9 | 9 | 1 | 4 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 5 | 8 | 8 | 5 | 9 | 9 | 1 | 8 |
Sum = 79 · next multiple of 10 = 80 · check digit = 1 · actual last digit = 1
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.