Individual provider Active NPI

Kwabena Owusu

  • Psychiatry Physician
  • Towson, MD
National Provider Identifier
1215580816
Registry record updated Jul 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
R199760 Issued in MD
Practice address
205 E Joppa Rd Ste 106
Towson, MD 21286-3203
Phone
(410) 337-0007
NPI assigned
Jul 23, 2019
Last updated
Jul 23, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X R199760 MD Primary

Addresses

Primary practice location

205 E Joppa Rd Ste 106
Towson, MD 21286-3203

Mailing address

205 E Joppa Rd Ste 106
Towson, MD 21286-3203
Phone (410) 337-0007

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20191011000029 MD Practitioner - Nurse Practitioner 6305177031 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

200 Booth St
Elkton, MD 21921-5657
Phone (410) 996-5104

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Upper Bay Counseling and Support Services, Inc CurrentSince Sep 1, 2019 Accepting new patients
Charito Quintero-Howard Child and Adult Psychiatry Single Specialty CurrentSince Oct 12, 2019 Accepting new patients
Upper Bay Counseling & Support Services, Inc. Single Specialty CurrentSince Sep 1, 2019 Accepting new patients

Locations

200 Booth St
Elkton, MD 21921
Phone (410) 996-3400

205 E Joppa Rd
Ste 106
Towson, MD 21286
Phone (410) 337-0007

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1563840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563840000000",
    "number": "1215580816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 E JOPPA RD STE 106",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212863203",
            "telephone_number": "410-337-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E JOPPA RD STE 106",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212863203",
            "telephone_number": "410-337-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWUSU",
        "first_name": "KWABENA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-23",
        "last_updated": "2019-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "R199760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

Verify at the official NPI Registry.