Kofo Abiru-Adebambo

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R182386 Issued in MD

Practice address

1232 Race Road
Ste 403
Rosedale, MD 21237-1483

Phone

(443) 868-7101

Fax

(443) 732-0054

NPI assigned

Oct 26, 2021

Last updated

Dec 28, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kolossal Healthcare Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
  • NPI 1013448760

  Psychiatric/Mental Health

  Medicare reassignment NPD Authorized official
• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  MD, Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Uncaged Potential LLC

  • Clinical Social Worker
  • Baltimore, MD
  • NPI 1225754831
  Medicare reassignment NPD
• Optimize Medical Group

  • Adult Health Nurse Practitioner
  • Pikesville, MD
  • NPI 1952818999
  NPD (past)

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

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735344000000",
    "number": "1548924459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 GUILFORD AVE UNIT 2010",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212023707",
            "telephone_number": "408-697-9392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1232 RACE ROAD",
            "address_2": "STE 403",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212371483",
            "telephone_number": "443-868-7101",
            "fax_number": "443-732-0054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3261 Old Washington Rd Ste 2020",
            "address_purpose": "LOCATION",
            "city": "Waldorf",
            "state": "MD",
            "postal_code": "206023231",
            "country_code": "US",
            "telephone_number": "301-263-3786",
            "fax_number": "301-263-3804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABIRU-ADEBAMBO",
        "first_name": "KOFO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-26",
        "last_updated": "2024-12-28",
        "certification_date": "2024-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R182386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• A New Day Behavioral Health Services LLC
• A Rey of Hope Counseling Services
• Anahita Abdehou, DDS
• Able Angels Healthcare Services
• Noelle Abrahams
• Absolute Care Services LLC
• Adeola Ojuolape Adesuyi, PHARMD
• Dipa Adhikari, NP

• Psychiatric/Mental Health Nurse Practitioner in Rosedale, MD
• Providers in Rosedale, 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 Dec 28, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.