Individual provider Active NPI

Leslie N Ngong-Nassah, NURSE PRACTITIONER

  • Psychiatric/Mental Health Nurse Practitioner
  • Beltsville, MD
National Provider Identifier
1265200950
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R215510 Issued in MD
Practice address
12401 Brickyard Blvd Apt 2106
Beltsville, MD 20705-1636
Phone
(240) 374-8280
NPI assigned
Dec 13, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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 R215510 MD Primary

Addresses

Primary practice location

12401 Brickyard Blvd Apt 2106
Beltsville, MD 20705-1636

Mailing address

5505.5 Reisterstown Rd
Baltimore, MD 21215
Phone (443) 493-7985

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 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
I20240411003730 DC Practitioner - Nurse Practitioner 1355780297 Reassigns benefits to 1 organization
I20240701000906 MD Practitioner - Nurse Practitioner 1355780297 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthy Mind Foundation Africa LimitedGroup PAC ID 9234527524, 4 clinicians

Practice addresses (Care Compare)

5505 /2 Reisterstown Rd
Baltimore, MD 21215-4406
Phone (410) 624-7970

8101 Sandy Spring Rd
Suite 300W29
Laurel, MD 20707-3596
Phone (443) 493-7985

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R215510MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Mind Foundation Africa Limited Psychiatric/Mental Health CurrentSince Jan 27, 2024 Accepting new patients
Healthy Mind Foundation Africa Limited CurrentSince Jan 27, 2024 Accepting new patients

Locations

5505 Reisterstown Rd
Baltimore, MD 21215
Phone (301) 541-7178

8101 Sandy Spring Rd
Ste 300W29
Laurel, MD 20707
Phone (443) 493-7985

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": "1702425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1265200950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5505.5 REISTERSTOWN RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21215",
            "telephone_number": "443-493-7985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12401 BRICKYARD BLVD APT 2106",
            "city": "BELTSVILLE",
            "state": "MD",
            "postal_code": "207051636",
            "telephone_number": "240-374-8280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGONG-NASSAH",
        "first_name": "LESLIE",
        "middle_name": "N",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-13",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R215510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beltsville, MD

Sources for this page

Verify at the official NPI Registry.