Mabel Brossa

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R172398 Issued in MD

Practice address

20029 Mattingly Ter
Gaithersburg, MD 20879-4502

Phone

(240) 899-3239

NPI assigned

Mar 1, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Valor Health Inc

  • Multi-Specialty Clinic/Center
  • Glen Burnie, MD
  • NPI 1427576040

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  DC, Psychiatric/Mental Health

  Medicare reassignment NPD

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

{
    "created_epoch": "1646092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1467108233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20029 MATTINGLY TER",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208794502",
            "telephone_number": "240-899-3239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20029 MATTINGLY TER",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208794502",
            "telephone_number": "240-899-3239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROSSA",
        "first_name": "MABEL",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-01",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R172398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Briles
• Alisha Antoinette Broadus
• Matthew Brodak, O.D.
• Sharon Agnes Brooks, CRNP, FNP-BC
• Marita N Broome, M.D.
• Danielle Brough
• Takeisha Loretta Brown Blackwell
• Aaleya Orvillee Brown
• Allison Brown
• Asjoure Brown, LCPC

• Psychiatric/Mental Health Nurse Practitioner in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.