Individual provider Active NPI

Yah Rochelle Kilikpo, CRNP

  • Family Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1366077133
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R255289 Issued in MD
Practice address
301 Saint Paul St Ste 605
Baltimore, MD 21202-2102
Phone
(410) 332-1111
Fax
(410) 332-1752
NPI assigned
Mar 11, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP021282 PA
Family Nurse Practitioner 363LF0000X R255289 MD Primary

Addresses

Primary practice location

301 Saint Paul St Ste 605
Baltimore, MD 21202-2102

Mailing address

1589 Sulphur Spring Rd Ste 109
Baltimore, MD 21227-2542
Phone (443) 575-4880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 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
I20221007001615 MD Practitioner - Nurse Practitioner 1850715111 Reassigns benefits to 2 organizations
I20250402002111 DC Practitioner - Nurse Practitioner 1850715111 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Synergy Medical Group LLCGroup PAC ID 0749644177, 102 clinicians

Practice addresses (Care Compare)

1205 York Rd
Lutherville, MD 21093-6211
Phone (443) 325-0031

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R255289MDMDFamily Nurse Practitioner
SP021282PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Medical Group LLC Current Accepting new patients
Synergy Medical Group LLC Current Accepting new patients
Johns Hopkins University CurrentSince Jan 5, 2023 Accepting new patients
Johns Hopkins University CurrentSince Jan 5, 2023 Accepting new patients
Synergy Medical Group LLC CurrentSince Jan 12, 2025 Accepting new patients
Johns Hopkins University Current Accepting new patients
Synergy Medical Group LLC CurrentSince Dec 22, 2024 Accepting new patients
Synergy Medical Group LLC CurrentSince Dec 22, 2024 Accepting new patients

Locations

5601 Loch Raven Blvd
Baltimore, MD 21239
Phone (443) 444-4714

3210 Powder Mill Rd
Hyattsville, MD 20783
Phone (301) 937-3939

1205 York Rd
Ste 11
Timonium, MD 21093
Phone (443) 325-0031

Organizations & group practices 9

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1583884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1366077133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1589 SULPHUR SPRING RD STE 109",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212272542",
            "telephone_number": "443-575-4880",
            "fax_number": "443-575-4891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 SAINT PAUL ST STE 605",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022102",
            "telephone_number": "410-332-1111",
            "fax_number": "410-332-1752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILIKPO",
        "first_name": "YAH",
        "middle_name": "ROCHELLE",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-11",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP021282",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R255289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.