Individual provider Active NPI

Benson K. Mboche, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1699317719
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R183057 Issued in MD
Practice address
3730 Falls Rd
Baltimore, MD 21211-1844
Phone
(443) 629-8645
NPI assigned
Oct 9, 2019
Last updated
Jun 24, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R183057 MD Primary
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X R183057 MD

Addresses

Primary practice location

3730 Falls Rd
Baltimore, MD 21211-1844

Mailing address

3730 Falls Rd
Baltimore, MD 21211-1844
Phone (443) 629-8645

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210505000868 MD Practitioner - Nurse Practitioner 5597174466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optimum Health Systems, Inc.Group PAC ID 8729010228, 2 clinicians

Practice addresses (Care Compare)

2300 Garrison Blvd
Suite 104
Baltimore, MD 21216-2308
Phone (410) 233-6200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R183057MDMDPsychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Optimum Health Systems, Inc. Single Specialty CurrentSince Nov 18, 2021 Accepting new patients

Locations

2300 Garrison Blvd
Ste 104
Baltimore, MD 21216
Phone (410) 233-6200

Organizations & group practices 2

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": "1570579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1699317719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3730 FALLS RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212111844",
            "telephone_number": "443-629-8645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3730 FALLS RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212111844",
            "telephone_number": "443-629-8645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBOCHE",
        "first_name": "BENSON",
        "middle_name": "K.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-09",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R183057",
            "primary": true
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R183057",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.