Samuel Bomo Koroma

Primary specialty

Group Psychotherapy PsychologistTaxonomy code 103TP2701X

Practice address

920 Bellevue St SE
Washington, DC 20032-6030

Phone

(202) 562-4939

NPI assigned

May 2, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1651449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1619612934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 3RD ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200026274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 BELLEVUE ST SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200326030",
            "telephone_number": "202-562-4939"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1140 3rd St NE",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200026274",
            "country_code": "US",
            "telephone_number": "202-500-6617",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOROMA",
        "first_name": "SAMUEL",
        "middle_name": "BOMO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-02",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "DC",
            "license": "LC50078067",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohamed Koroma
• Mohamed Ibrahim Koroma
• Mohamed Maadakin Koroma
• Osainatu Koroma
• Saffie Temple Koroma
• Selina Koroma
• Sulaiman Koroma
• Umaru Vaama Koroma
• Zainab Yeabu Koroma, HHA
• Atim Koromah

• All providers in Washington, DC
• Group Psychotherapy Psychologist in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.