Individual provider Active NPI

Nicole Nugent-Gyesie, CRNP PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1548914005
Registry record updated Feb 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R203916 Issued in MD
Practice address
4229 York Rd
Baltimore, MD 21212-4884
Phone
(410) 961-2176
NPI assigned
Feb 3, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R203916 MD Primary

Addresses

Primary practice location

4229 York Rd
Baltimore, MD 21212-4884

Mailing address

4229 York Rd Ste 201
Baltimore, MD 21212-4884
Phone (667) 392-0170

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
I20220907002562 MD Practitioner - Nurse Practitioner 5597149757 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4229 York Rd
Suite 201
Baltimore, MD 21212-4884
Phone (667) 392-0170

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Toller Enterprises LLC Psychiatric/Mental Health CurrentSince Aug 24, 2022 Accepting new patients
Blackstar Solutions LLC CurrentSince Sep 28, 2025 Accepting new patients
Blackstar Solutions LLC CurrentSince Jan 1, 2022 Accepting new patients

Locations

2232 E Monument St
Baltimore, MD 21205
Phone (667) 207-3552

10451 Mill Run Cir
Ste 452
Owings Mills, MD 21117
Phone (667) 392-0170

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": "1643846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770508800000",
    "number": "1548914005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4229 YORK RD STE 201",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212124884",
            "telephone_number": "667-392-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4229 YORK RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212124884",
            "telephone_number": "410-961-2176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUGENT-GYESIE",
        "first_name": "NICOLE",
        "credential": "CRNP PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-03",
        "last_updated": "2026-02-08",
        "certification_date": "2026-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R203916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.