Individual provider Active NPI

Baindu Leemu Mansaray-Smith, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Montgomery Village, MD
National Provider Identifier
1245014778
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R194518 Issued in MD
Practice address
19310 Club House Rd
Montgomery Village, MD 20886-3029
Phone
(301) 921-0445
NPI assigned
Aug 24, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R194518 MD Primary

Addresses

Primary practice location

19310 Club House Rd
Montgomery Village, MD 20886-3029

Mailing address

11602 Brigit CT
Bowie, MD 20720-4486
Phone (240) 441-7732

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20240229000142 DC Practitioner - Nurse Practitioner 8628413762 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rahel G. Yirga MD PCGroup PAC ID 0648335372, 25 clinicians

Practice addresses (Care Compare)

11602 Brigit CT
Bowie, MD 20720-4486
Phone (240) 441-7732

16940 Georgia Ave
Olney, MD 20832-2424
Phone (301) 570-0525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R194518MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Leemu Behavioral Health Services LLC CurrentSince Jan 12, 2025 Accepting new patients
Rahel G. Yirga MD PC CurrentSince Feb 1, 2024 Accepting new patients

Locations

4922 Lasalle Rd
Hyattsville, MD 20782
Phone (301) 445-3501

6035 Burke Centre Pkwy
Ste 390
Burke, VA 22015
Phone (703) 978-0756

Interoperability endpoints

  • Direct secure messaging: leemubehavioralhealthservices.bainduleemmansaraysmith@161094.advancedmd-direct.com

Organizations & group practices 2

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": "1692835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1245014778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11602 BRIGIT CT",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207204486",
            "telephone_number": "240-441-7732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19310 CLUB HOUSE RD",
            "city": "MONTGOMERY VILLAGE",
            "state": "MD",
            "postal_code": "208863029",
            "telephone_number": "301-921-0445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSARAY-SMITH",
        "first_name": "BAINDU",
        "middle_name": "LEEMU",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-24",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R194518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery Village, MD

Sources for this page

Verify at the official NPI Registry.