Individual provider Active NPI

Bolanle Silifat Kassim

  • Home Health Aide
  • Hyattsville, MD
National Provider Identifier
1588256481
Registry record updated Feb 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
HHA15360 Issued in DC
Practice address
3402 55TH Ave Apt 204
Hyattsville, MD 20784-1016
Phone
(404) 509-6668
NPI assigned
Feb 11, 2021
Last updated
Feb 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X HHA15360 DC Primary

Addresses

Primary practice location

3402 55TH Ave Apt 204
Hyattsville, MD 20784-1016

Mailing address

3402 55TH Ave Apt 204
Hyattsville, MD 20784-1016
Phone (404) 509-6668

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
HHA15360DCMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1613001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1588256481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3402 55TH AVE APT 204",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207841016",
            "telephone_number": "404-509-6668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3402 55TH AVE APT 204",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207841016",
            "telephone_number": "404-509-6668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASSIM",
        "first_name": "BOLANLE",
        "middle_name": "SILIFAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-11",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "HHA15360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyattsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.