NPIMap

Organization Active NPI

MD Behavioral Health LLC

Doing business as Bowie Town Behavioral

  • Psychiatry Physician
  • Bowie, MD
National Provider Identifier
1346021813
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
MD BEHAVIORAL HEALTH LLC
Doing business as
Bowie Town Behavioral
Practice address
4000 Mitchellville Rd Ste A414
Bowie, MD 20716-3142
Phone
(301) 249-8100
Fax
(301) 390-8086
NPI assigned
Oct 11, 2023
Last updated
Oct 11, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Authorized official

Name
Mr. Ayokunle Oluleye
Title
Director
Phone
(443) 756-5092

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X Primary

Addresses

Primary practice location

4000 Mitchellville Rd Ste A414
Bowie, MD 20716-3142

Mailing address

4000 Mitchellville Rd Ste A414
Bowie, MD 20716-3142
Phone (301) 249-8100

Other names 1

  • Bowie Town Behavioral Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231106001927 DC Part B Supplier - Clinic/Group Practice 8820445364 Receives reassigned benefits from 16 practitioners
Practice locations: Bowie, MD; Takoma Park, MD

National Provider Directory

National Provider Directory
Tax ID family
MD Behavioral Health LLC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1696982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696982400000",
    "number": "1346021813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 MITCHELLVILLE RD STE A414",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207163142",
            "telephone_number": "301-249-8100",
            "fax_number": "301-390-8086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 MITCHELLVILLE RD STE A414",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207163142",
            "telephone_number": "301-249-8100",
            "fax_number": "301-390-8086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MD BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-11",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A",
        "authorized_official_last_name": "OLULEYE",
        "authorized_official_first_name": "AYOKUNLE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "443-756-5092",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bowie Town Behavioral",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.