Agnes Ashu Agbortarh
Individual provider Active NPI Family Nurse Practitioner · Columbia, MD
NPI 1346901865 · NPPES record last updated Apr 26, 2024
Key facts
- NPI
- 1346901865
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- R216957 (MD)
- Practice address
- 5457 Twin Knolls Rd Ste 100
Columbia, MD 21045-3263 - Phone
- (410) 689-7400
- NPI assigned
- Jan 6, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Optimize Medical Group
Practice addresses (Care Compare)
1051 Brightseat Rd
Landover, MD 20785-3738
Phone (240) 487-4400
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MD, DC
- 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 |
|---|---|---|---|---|
| I20220413000405 | MD | Practitioner - Nurse Practitioner | 3971999293 | Reassigns benefits to 4 organizations |
| I20220413000532 | DC | Practitioner - Nurse Practitioner | 3971999293 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R216957 | MD | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Seasons Medical Group of Maryland PC | Current |
Accepting new patients | |
| Optimize Medical Group | Current |
Accepting new patients | |
| Viewpoint Wellness LLC | Current |
Accepting new patients | |
| Health Practice Partners LLC | Current |
Accepting new patients | |
| Post Acute Health Care Services LLC | Past | Accepting new patients | |
| Devine Family Care Practice LLC | Past |
Accepting new patients |
Locations
2327 N Charles St
Baltimore, MD 21218
Phone (410) 889-8500
5457 Twin Knolls Rd
Ste 100
Columbia, MD 21045
Phone (410) 689-7400
1051 Brightseat Rd
Landover, MD 20785
Phone (240) 487-4400
8028 Ritchie Hwy
Ste 210
Pasadena, MD 21122
Phone (410) 733-3292
1314 Bedford Ave
Ste 113
Pikesville, MD 21208
Phone (443) 868-7956
1232 Race Rd
Ste 403
Rosedale, MD 21237
Phone (480) 878-7806
17855 Dallas Pkwy
Ste 200
Dallas, TX 75287
Phone (972) 201-3800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R216957 | MD | Yes |
Addresses
Primary practice location
5457 Twin Knolls Rd Ste 100
Columbia, MD 21045-3263
Mailing address
1232 Race Road
Ste 403
Rosedale, MD 21237-1256
Phone (443) 868-7101
Other practice location 1
7131 Liberty Rd
Gywnn Oaks, MD 21207
Phone (410) 963-9577
Other practice location 2
1232 Race Road
Ste 403
Rosedale, MD 21237-1256
Phone (443) 868-7101
Other providers in Columbia, MD
- Farzaneh Agahi
- Puneet Agarwal
- Nickolas Theophilos Agathis
- Sarah Bong Agboli
- Irys Ako Agbortabi
- Cecily Marie L. Agcaoili
- Age Right Care LLC
- Agewell Alliance
- Saavitri Aggarwal
- Fizza Agha
All providers in Columbia, MD · Family 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 26, 2024. 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.