Individual provider Active NPI

Henrietta Yacobah Van-Segbefia

  • Gerontology Nurse Practitioner
  • Laurel, MD
National Provider Identifier
1134826928
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
R186966 Issued in MD
Practice address
8570 Eastern Morning Run
Laurel, MD 20723-5863
Phone
(240) 491-8830
NPI assigned
Feb 13, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X R186966 MD Primary

Addresses

Primary practice location

8570 Eastern Morning Run
Laurel, MD 20723-5863

Mailing address

8570 Eastern Morning Run
Laurel, MD 20723-5863
Phone (240) 491-8830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230726003307 MD Practitioner - Nurse Practitioner 1052772886 Reassigns benefits to 3 organizations
I20230726003535 DC Practitioner - Nurse Practitioner 1052772886 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington Cardiovascular Institute, LLCGroup PAC ID 7517903982, 16 clinicians

Practice addresses (Care Compare)

75 Thomas Johnson Dr
Suite I
Frederick, MD 21702-4895
Phone (301) 891-2500

7610 Carroll Ave
Suite 100
Takoma Park, MD 20912-6311
Phone (301) 891-2500

Merit-based Incentive Payment System (MIPS)

Final score
89.78 of 100Reported as group
Quality
78.26
Improvement activities
40
Cost
61.58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R186966MDMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
WVS Takoma Park LLC CurrentSince Sep 6, 2024 Accepting new patients
WVS Frederick ASC LLC CurrentSince Feb 26, 2024 Accepting new patients
Washington Cardiovascular Institute LLC CurrentSince Jul 1, 2023 Accepting new patients
Washington Cardiovascular Institute LLC CurrentSince Jul 1, 2023 Accepting new patients

Locations

351 W Camden St
Fl 201
Baltimore, MD 21201
Phone (410) 541-7800

75 Thomas Johnson Dr
Ste I
Frederick, MD 21702
Phone (301) 378-0608

8816 Jericho City Dr
North Englewood, MD 20785
Phone (301) 808-0341

7610 Carroll Ave
Ste 100
Takoma Park, MD 20912

Interoperability endpoints

  • Direct secure messaging: henrietta.van-segbefia.1@10710.direct.athenahealth.com

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1676246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1134826928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8570 EASTERN MORNING RUN",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207235863",
            "telephone_number": "240-491-8830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8570 EASTERN MORNING RUN",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207235863",
            "telephone_number": "240-491-8830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN-SEGBEFIA",
        "first_name": "HENRIETTA",
        "middle_name": "YACOBAH",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-13",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MD",
            "license": "R186966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

Verify at the official NPI Registry.