Itoro Abatai
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Baltimore, MD
NPI 1245839653 · NPPES record last updated Apr 15, 2025
Key facts
- NPI
- 1245839653
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- R220850 (MD)
- Practice address
- 2300 Garrison Blvd Ste 205
Baltimore, MD 21216-2309 - Phone
- (443) 691-5498
- NPI assigned
- Oct 19, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- 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
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211006003507 | MD | Practitioner - Nurse Practitioner | 0042617953 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R220850 | MD | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Chance Healthcare Services | Psychiatric/Mental Health | Current |
Accepting new patients |
Locations
2300 Garrison Blvd
Ste 205
Baltimore, MD 21216
Phone (443) 691-5498
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | R220850 | MD | Yes |
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
Other providers in Baltimore, MD
- Elisabeth Abamina-Lette
- Rafia Abanga
- Rachelle Vera Abante
- Chinwe Abaraoha
- Kara Angela Abarcar
- Shastine Abate
- Jared Abay
- Shahem Mohammad Abbarh
- Fouad M Abbas
- Hashim Abbas
All providers in Baltimore, MD · Psychiatric/Mental Health Nurse Practitioner in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 15, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.