Individual provider Active NPI

Oloruntobi O Agbelusi, CRNP

  • Family Nurse Practitioner
  • Greenbelt, MD
National Provider Identifier
1487888368
Registry record updated Dec 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R251076 Issued in MD
Practice address
7501 Greenway Center Dr
Greenbelt, MD 20770-3514
Phone
(646) 387-7440
NPI assigned
May 7, 2009
Last updated
Dec 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R251076 MD Primary

Addresses

Primary practice location

7501 Greenway Center Dr
Greenbelt, MD 20770-3514

Mailing address

1036 Saint Nicholas Dr
Waldorf, MD 20603-4757
Phone (240) 261-7170

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
I20220707000679 MD Practitioner - Nurse Practitioner 5395162903 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Calverthealth Medical Group, LLCGroup PAC ID 2163562695, 50 clinicians

Practice addresses (Care Compare)

110 Hospital Rd
Suite 101
Prince Frederick, MD 20678-4019
Phone (410) 535-8195

Merit-based Incentive Payment System (MIPS)

Final score
86.48 of 100Reported as group
Quality
74.54
Promoting interoperability
99
Improvement activities
40
Cost
81.24

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R251076MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Calverthealth Medical Group, LLC CurrentSince Jan 1, 2023 Accepting new patients
Calverthealth Medical Group, LLC CurrentSince Sep 1, 2024 Accepting new patients
Calverthealth Medical Group, LLC CurrentSince Sep 1, 2024 Accepting new patients
Bay Area Rehab & Medical PastSince Aug 13, 2020 Accepting new patients

Locations

8924 Chesapeake Ave
North Beach, MD 20714
Phone (410) 257-7279

110 Hospital Rd
Ste 101
Prince Frederick, MD 20678
Phone (410) 535-8176

1036 Saint Nicholas Dr
Waldorf, MD 20603
Phone (410) 934-0580

1036 Saint Nicholas Dr
Unit 101
Waldorf, MD 20603
Phone (240) 261-7170

Organizations & group practices 4

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": "1241654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1487888368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1036 SAINT NICHOLAS DR",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034757",
            "telephone_number": "240-261-7170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7501 GREENWAY CENTER DR",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207703514",
            "telephone_number": "646-387-7440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGBELUSI",
        "first_name": "OLORUNTOBI",
        "middle_name": "O",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-07",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R251076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenbelt, MD

Sources for this page

Verify at the official NPI Registry.