Individual provider Active NPI

Elsa Gherezghiher Asghedom, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Frederick, MD
National Provider Identifier
1346069630
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AC006972 Issued in MD
Practice address
172 Thomas Johnson Dr Ste 203L2
Frederick, MD 21702-4402
Phone
(703) 568-5059
NPI assigned
Oct 4, 2024
Last updated
May 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2026

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 AC006972 MD Primary

Addresses

Primary practice location

172 Thomas Johnson Dr Ste 203L2
Frederick, MD 21702-4402

Mailing address

172 Thomas Johnson Dr Ste 203L2
Frederick, MD 21702-4402
Phone (703) 568-5059

Other practice location 1

14300 Gallant Fox Ln Ste 223
Bowie, MD 20715-4033
Phone (301) 828-2655

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
I20250428001598 DC Practitioner - Nurse Practitioner 5698291219 Reassigns benefits to 1 organization
Practice locations: Dunkirk, MD
I20251017003092 MD Practitioner - Nurse Practitioner 5698291219 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

172 Thomas Johnson Dr
Suite 203L2
Frederick, MD 21702-4402

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AC006972MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Mental Health Services LLC Psychiatric/Mental Health CurrentSince Sep 5, 2025 Accepting new patients
All Time Psychiatry LLC CurrentSince Mar 2, 2025 Accepting new patients

Locations

14300 Gallant Fox Ln
Ste 223
Bowie, MD 20715
Phone (301) 828-2655

172 Thomas Johnson Dr
Ste 203L2
Frederick, MD 21702
Phone (703) 568-5059

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, 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": "1728000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1346069630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 THOMAS JOHNSON DR STE 203L2",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024402",
            "telephone_number": "703-568-5059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 THOMAS JOHNSON DR STE 203L2",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024402",
            "telephone_number": "703-568-5059"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14300 Gallant Fox Ln Ste 223",
            "address_purpose": "LOCATION",
            "city": "Bowie",
            "state": "MD",
            "postal_code": "207154033",
            "country_code": "US",
            "telephone_number": "301-828-2655",
            "fax_number": "301-281-4002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ASGHEDOM",
        "first_name": "ELSA",
        "middle_name": "GHEREZGHIHER",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-04",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "AC006972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.