Individual provider Active NPI

Itoro Abatai

  • Psychiatric/Mental Health Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1245839653
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R220850 Issued in MD
Practice address
2300 Garrison Blvd Ste 205
Baltimore, MD 21216-2309
Phone
(443) 691-5498
NPI assigned
Oct 19, 2020
Last updated
Apr 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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 R220850 MD Primary

Addresses

Primary practice location

2300 Garrison Blvd Ste 205
Baltimore, MD 21216-2309

Mailing address

9620 Maxwell Rd
Middle River, MD 21220-3792
Phone (443) 691-5498

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
I20211006003507 MD Practitioner - Nurse Practitioner 0042617953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2300 Garrison Blvd
Suite 205
Baltimore, MD 21216-2309
Phone (443) 800-2814

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R220850MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Chance Healthcare Services Psychiatric/Mental Health CurrentSince Aug 1, 2021 Accepting new patients

Locations

2300 Garrison Blvd
Ste 205
Baltimore, MD 21216
Phone (443) 691-5498

Organizations & group practices 1

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": "1603065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1245839653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9620 MAXWELL RD",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212203792",
            "telephone_number": "443-691-5498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 GARRISON BLVD STE 205",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212162309",
            "telephone_number": "443-691-5498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABATAI",
        "first_name": "ITORO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-19",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R220850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.