Individual provider Active NPI

Osita Mgbendi, DNP- PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Fairfax, VA
National Provider Identifier
1639855299
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024187411 Issued in VA
Practice address
10721 Main St Ste 2400
Fairfax, VA 22030-6902
Phone
(571) 977-6870
NPI assigned
Jun 27, 2023
Last updated
May 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2025

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 0024187411 VA Primary

Addresses

Primary practice location

10721 Main St Ste 2400
Fairfax, VA 22030-6902

Mailing address

1000 Palisades Cir
Manassas Park, VA 20111-8055
Phone (973) 610-1334

Other practice location 1

1000 Palisades Cir
Manassas Park, VA 20111-8055
Phone (973) 610-1334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, 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

Enrollment IDStateProvider typePAC IDDetails
I20241028000264 VA Practitioner - Nurse Practitioner 3971036195 Reassigns benefits to 4 organizations
I20250414003436 DC Practitioner - Nurse Practitioner 3971036195 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aevum BH VA LLCGroup PAC ID 3274067210, 35 clinicians

Practice addresses (Care Compare)

380 Millwood Ave
Winchester, VA 22601-4453
Phone (804) 446-1710

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Associates in Psychiatry PC Psychiatric/Mental Health CurrentSince Apr 9, 2025 Accepting new patients
Rhodium Care Group Inc CurrentSince May 22, 2025 Accepting new patients
Dominion Outpatient Services, LLC CurrentSince Sep 1, 2024 Accepting new patients
Aevum BH VA LLC Psychiatric/Mental Health CurrentSince Aug 18, 2025 Accepting new patients
Aevum Behavioral Health VA LLC Psychiatric/Mental Health PastSince Sep 1, 2024 Accepting new patients

Locations

24560 Southpoint Dr
Ste 260
Aldie, VA 20105
Phone (571) 248-7472

8830 Virginia St
Amelia Ct Hse, VA 23002
Phone (804) 561-5611

2501 N Glebe Rd
Ste 303
Arlington, VA 22207
Phone (703) 485-9519

10721 Main St
Ste 2400
Fairfax, VA 22030
Phone (703) 270-0225

2960 Sleepy Hollow Rd
Falls Church, VA 22044
Phone (703) 304-7764

4403 Forest Hill Ave
Richmond, VA 23225
Phone (804) 231-0231

3025 Peters Creek Rd NW
Ste A
Roanoke, VA 24019
Phone (540) 352-7611

24440 Stone Springs Blvd
Sterling, VA 20166
Phone (571) 206-8696

380 Millwood Ave
Winchester, VA 22601
Phone (540) 667-7010

110 Lauck Dr
Winchester, VA 22603
Phone (540) 667-7830

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1639855299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 PALISADES CIR",
            "city": "MANASSAS PARK",
            "state": "VA",
            "postal_code": "201118055",
            "telephone_number": "973-610-1334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10721 MAIN ST STE 2400",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306902",
            "telephone_number": "571-977-6870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Palisades Cir",
            "address_purpose": "LOCATION",
            "city": "Manassas Park",
            "state": "VA",
            "postal_code": "201118055",
            "country_code": "US",
            "telephone_number": "973-610-1334",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MGBENDI",
        "first_name": "OSITA",
        "credential": "DNP- PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-27",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024187411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.