Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Omoniyi Tunde Modupe, DNP-CRNA

Individual provider Certified Registered Nurse Anesthetist · NPI 1942972690

Omoniyi Tunde Modupe, DNP-CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Camden, New Jersey. Qualified in 2021, 5 years ago. Practices with Rgal Anesthesia Services LLC, a 129-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New Jersey and Pennsylvania.

Years since qualifying
5
Licensed in
NJ, PA
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

1 Cooper Plz Dept OF
Camden, NJ 08103-1461
Phone: (856) 342-2425
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3401 N Broad St, Philadelphia, PA 19140-5103 — (215) 707-2000

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 26NJ15060600 (NJ)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence RN685335 (PA)

Record details

NPI number1942972690
Entity typeIndividual (Type 1)
GenderMale
Credentials DNP-CRNA
Sole proprietorNo
NPI enumeratedOctober 1, 2021
Last updated in NPPESOctober 22, 2024
Certification dateOctober 21, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Rgal Anesthesia Services Llc — 129 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Camden