Individual provider Active NPI

Nicolas Kuiate Tekam, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Laurel, MD
National Provider Identifier
1356775464
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN215137 Issued in MD
Practice address
9704 Brevard St
Laurel, MD 20723-1920
Phone
(202) 702-4778
NPI assigned
Aug 26, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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 RN215137 MD Primary

Addresses

Primary practice location

9704 Brevard St
Laurel, MD 20723-1920

Mailing address

6501 N Charles St
Baltimore, MD 21204-6819
Phone (202) 702-4778

Other practice location 1

6501 N Charles St
Baltimore, MD 21204-6819
Phone (202) 702-4778

Other names 1

  • Nicolas Kuiate Tekam Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220426001777 MD Practitioner - Nurse Practitioner 8426441395 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

5410 Lynx LN
Suite 285
Columbia, MD 21044-2483
Phone (410) 740-3240

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN215137MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC CurrentSince Aug 10, 2022 Accepting new patients
NKT Behavioral Health Services LLC Psychiatric/Mental Health Current Accepting new patients
Salus Health Inc CurrentSince Apr 6, 2022 Accepting new patients

Locations

1020 Saint Paul St
Baltimore, MD 21202
Phone (410) 529-0348

5410 Lynx Ln
Ste 285
Columbia, MD 21044
Phone (410) 740-3240

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

Organizations & group practices 3

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": "1377475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1356775464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212046819",
            "telephone_number": "202-702-4778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9704 BREVARD ST",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207231920",
            "telephone_number": "202-702-4778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6501 N Charles St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212046819",
            "country_code": "US",
            "telephone_number": "202-702-4778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUIATE TEKAM",
        "first_name": "NICOLAS",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-26",
        "last_updated": "2022-02-21",
        "certification_date": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "RN215137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLAS",
            "last_name": "KUIATE TEKAM",
            "credential": "PMHNP-BC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Laurel, MD

Sources for this page

Verify at the official NPI Registry.