Individual provider Active NPI

Julius Fomengia

  • Psychiatric/Mental Health Nurse Practitioner
  • Laurel, MD
National Provider Identifier
1538688684
Registry record updated Aug 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R148632 Issued in MD
Practice address
13994 Baltimore Ave
Laurel, MD 20707-5087
Phone
(240) 463-3357
NPI assigned
Sep 10, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X R148632 MD Primary
Family Nurse Practitioner 363LF0000X R148632 MD

Addresses

Primary practice location

13994 Baltimore Ave
Laurel, MD 20707-5087

Mailing address

7411 Riggs Rd Ste 210
Hyattsville, MD 20783-4246
Phone (240) 463-3357

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC, VA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20180109001705 MD Practitioner - Nurse Practitioner 7416216965 Reassigns benefits to 2 organizations
I20180110000660 DC Practitioner - Nurse Practitioner 7416216965 Reassigns benefits to 2 organizations
I20260210000070 VA Practitioner - Nurse Practitioner 7416216965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychogeriatric Services LLCGroup PAC ID 6002719226, 122 clinicians
Prime Behavioral Health LLCGroup PAC ID 7214277839, 4 clinicians

Practice addresses (Care Compare)

12073 Tech Rd
Suite B
Silver Spring, MD 20904-7874
Phone (301) 593-1315

13994 Baltimore Ave
Suite 102
Laurel, MD 20707-5087
Phone (301) 477-2128

13994 Baltimore Ave
Suite 102
Laurel, MD 20707-5173
Phone (301) 477-2128

9950 Oak Lea CT
Ellicott City, MD 21042-3638
Phone (301) 477-2128

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Psychogeriatric Services LLC CurrentSince Dec 1, 2017 Accepting new patients
Prime Behavioral Health LLC CurrentSince Jan 22, 2019 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

13994 Baltimore Ave
Ste 102
Laurel, MD 20707
Phone (301) 477-2128

4101 Old National Pike
Mount Airy, MD 21771
Phone (301) 829-0800

12073 Tech Rd
Ste B
Silver Spring, MD 20904
Phone (240) 396-5873

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": "1505001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1538688684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7411 RIGGS RD STE 210",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207834246",
            "telephone_number": "240-463-3357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13994 BALTIMORE AVE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075087",
            "telephone_number": "240-463-3357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOMENGIA",
        "first_name": "JULIUS",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-10",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R148632",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R148632",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

Verify at the official NPI Registry.