Wakeelat A Adeoye

Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Baltimore, MD

NPI 1497317853 · NPPES record last updated Apr 12, 2022

Key facts

NPI
1497317853
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License
R214863 (MD)
Practice address
5411 0LD Fredrick Rd
Suite 7
Baltimore, MD 21229
Phone
(202) 415-0285
NPI assigned
Jul 5, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

15601 Peach Orchard Way
Bowie, MD 20716-1543
Phone (443) 200-3653

1657 Whitehead CT
FL 1
Baltimore, MD 21207-4037
Phone (443) 200-3653

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 IDStateProvider typePAC IDDetails
I20191104000903 MD Practitioner - Nurse Practitioner 5597097006 Reassigns benefits to 1 organization
I20200826001093 DC Practitioner - Nurse Practitioner 5597097006 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Blossom Care and Behavioral Services Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R214863 MD Yes

Addresses

Primary practice location

5411 0LD Fredrick Rd
Suite 7
Baltimore, MD 21229

Mailing address

1177 Annapolis Rd Ste 233
Odenton, MD 21113
Phone (202) 415-0285

Other practice location 1

1657 Whitehead Ct
Baltimore, MD 21207-4037
Phone (443) 200-3653

Other providers in Baltimore, MD

All providers in Baltimore, MD · Psychiatric/Mental Health Nurse Practitioner in Maryland

Sources for this page

Verify at the official NPI Registry.