Ida Mabelle Konchou, HHA

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R207705 Issued in MD

Practice address

6731 New Hampshire Ave Apt 409
Takoma Park, MD 20912-2801

Phone

(202) 545-0935

Fax

(202) 545-0934

NPI assigned

Jun 15, 2012

Last updated

Mar 20, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lifebridge Community Physicians IncGroup PAC ID 3678751468, 183 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sinai Hospital of Baltimore Hospital, Baltimore, MD, CCN 210012
• Northwest Hospital Center Hospital, Randallstown, MD, CCN 210040

Merit-based Incentive Payment System (MIPS)

Final score

83.23 of 100Reported as group

Quality

60.26

Promoting interoperability

100

Improvement activities

40

Cost

76.75

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lifebridge Community Physicians, Inc

  • Cardiovascular Disease Physician
  • Timonium, MD
  • NPI 1174815807
  Medicare reassignment Care Compare group NPD
• Tida Healthcare LLC

  • Psychiatry Physician
  • Crofton, MD
  • NPI 1629768775
  NPD Authorized official
• Lifebridge Community Physicians Inc

  • Psychiatry Physician
  • Baltimore, MD
  • NPI 1629719091
  NPD
• Lifebridge Community Physicians Inc

  • Cardiovascular Disease Physician
  • Lutherville, MD
  • NPI 1740086149
  NPD
• Hightower Behavioral Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Glen Burnie, MD
  • NPI 1972140069
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northwest Hospital Center, Inc.

  • General Acute Care Hospital
  • Randallstown, MD
  • NPI 1487695888
  Care Compare affiliation
• Sinai Hospital of Baltimore, Inc.

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1285672204
  Care Compare affiliation
• Sinai Hospital of Baltimore, Inc.

  dba Grace Medical Center, A Sinai Hospital Facility

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1487325874
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1339718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584662400000",
    "number": "1134482078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6731 NEW HAMPSHIRE AVE APT 409",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "209122801",
            "telephone_number": "202-545-0935",
            "fax_number": "202-545-0934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6731 NEW HAMPSHIRE AVE APT 409",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "209122801",
            "telephone_number": "202-545-0935",
            "fax_number": "202-545-0934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONCHOU",
        "first_name": "IDA",
        "middle_name": "MABELLE",
        "credential": "HHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-15",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R207705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cosmas K Kileo
• Louis Raymond Knight, LCSW-C
• Kelly Kolyer, LCSW-C
• Suzanne Belinda Komewo Nidjozem
• Hakeem T Komolafe, PHARMACIST
• Kouekam LLC
• Arezima Ouro Koulon
• Onorine Tai Kpwa
• Valerie Deoudes Kranias, M.S., C.G.C.
• Sharon S. Kreps, M.A.CCC-SLP

• Psychiatric/Mental Health Nurse Practitioner in Takoma Park, MD
• Providers in Takoma Park, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.