Similade Adetunji
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Annapolis, MD
NPI 1073155248 · NPPES record last updated Jan 8, 2025
Key facts
- NPI
- 1073155248
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 212163 (MD)
- Practice address
- 1600 Belle Dr
Annapolis, MD 21401-1147 - Phone
- (240) 401-5260
- Fax
- (240) 425-4255
- NPI assigned
- Oct 9, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1250 Connecticut Ave NW
Suite 700
Washington, DC 20036-2657
Phone (240) 401-5260
1600 Belle Dr
Annapolis, MD 21401-1147
Phone (240) 401-5260
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MD, DC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220210001462 | MD | Practitioner - Nurse Practitioner | 5193118354 | Reassigns benefits to 1 organization |
| I20231229001827 | DC | Practitioner - Nurse Practitioner | 5193118354 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 212163 | MD | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| E & G Allied Home Care Agency LLC | Current | Accepting new patients | |
| The Lily Valley Group, Inc. | Family | Current | Accepting new patients |
| The Lily Valley Group, Inc. | Family | Current |
Accepting new patients |
| Gold Shield Medical Services LLC | Past | Accepting new patients | |
| Parkway Medical Association LLC | Psychiatric/Mental Health | Past |
Accepting new patients |
Locations
1250 Connecticut Ave NW
Ste 700
Washington, DC 20036
Phone (202) 261-6598
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 212163 | MD | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | NP1044291 | DC | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 212163 | MD | Yes |
Addresses
Primary practice location
1600 Belle Dr
Annapolis, MD 21401-1147
Mailing address
1600 Belle Dr
Annapolis, MD 21401-1147
Phone (240) 506-2011
Other practice location 1
1600 Belle Dr
Annapolis, MD 21401-1147
Phone (240) 401-5260
Other providers in Annapolis, MD
- Tracy L Adams
- Kaysha Sherrie Addison
- Moncheri Harper Adebayo
- Folasade Adekolurejo
- Emmanuel O Adesanya
- Olutayo O Adewumi
- Elizabeth Ayotunde Adeyefa-Olasupo
- Adfinitas Health Palliative Services, LLC
- Negar Adib
- Aditya Chopra, MD, PC
All providers in Annapolis, MD · Psychiatric/Mental Health Nurse Practitioner in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.