Individual provider Active NPI

Abisola Osifade

  • Mental Health Counselor
  • Millersville, MD
National Provider Identifier
1699028787
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1110 Benfield Blvd Ste B
Millersville, MD 21108-2644
Phone
(410) 863-7213
Fax
(410) 863-7205
NPI assigned
Oct 26, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1110 Benfield Blvd Ste B
Millersville, MD 21108-2644

Mailing address

804 Landmark Dr Ste 118
Glen Burnie, MD 21061-4486
Phone (410) 863-7213

Other identifiers 1

IdentifierTypeStateIssuer
1699028787OtherMDNPI

Electronic endpoints 1

TypeEndpointUseAffiliation
RESTful URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201209000042 MD Practitioner - Clinical Social Worker 3274945688 Reassigns benefits to 1 organization
I20221226000012 DC Practitioner - Clinical Social Worker 3274945688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Maryland School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, 1,921 clinicians

Practice addresses (Care Compare)

12201 Plum Orchard Dr
Silver Spring, MD 20904-7803
Phone (301) 572-1000

1221 Mercantile LN
Largo, MD 20774-5374
Phone (301) 618-5700

7141 Security Blvd
Woodlawn Med Ctr
Baltimore, MD 21244-1811
Phone (443) 663-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Current Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Dec 7, 2020 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 14, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Dec 7, 2020 Accepting new patients

Locations

7070 Samuel Morse Dr
Columbia, MD 21046
Phone (410) 309-4600

2101 E Jefferson St
#4E
Rockville, MD 20852

2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853

2101 E Jefferson St
Ste 6W
Rockville, MD 20852
Phone (301) 816-5853

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

7141 Security Blvd
Windsor Mill, MD 21244
Phone (410) 281-6200

Organizations & group practices 4

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": "1351209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1699028787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 LANDMARK DR STE 118",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210614486",
            "telephone_number": "410-863-7213",
            "fax_number": "410-863-7205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 BENFIELD BLVD STE B",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211082644",
            "telephone_number": "410-863-7213",
            "fax_number": "410-863-7205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSIFADE",
        "first_name": "ABISOLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-26",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1699028787",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "REST",
            "endpointTypeDescription": "RESTful URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1110 Benfield Blvd Ste B",
            "city": "Millersville",
            "state": "MD",
            "country_code": "US",
            "postal_code": "211082644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Millersville, MD

Sources for this page

Verify at the official NPI Registry.