Individual provider Active NPI

Jane Kutsushi, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Waldorf, MD
National Provider Identifier
1710433693
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP1006184 Issued in DC
Practice address
2 Post Office Rd Unit 4A9497
Waldorf, MD 20602-2726
Phone
(202) 489-6118
NPI assigned
Aug 30, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X RN1006184 DC
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP1006184 DC Primary
Critical Care Medicine Registered Nurse 163WC0200X RN1006184 DC
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R166622 MD
Emergency Registered Nurse 163WE0003X RN1006184 DC
Medical-Surgical Registered Nurse 163WM0705X RN1006184 DC
Psychiatric/Mental Health Registered Nurse 163WP0808X NP1006184 DC

Addresses

Primary practice location

2 Post Office Rd Unit 4A9497
Waldorf, MD 20602-2726

Mailing address

9497 Pep Rally LN
Waldorf, MD 20603-3898
Phone (202) 489-6118

Other practice location 1

1221 Gallatin St NW
Washington, DC 20011-6915
Phone (202) 489-6118

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 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
I20240828000631 DC Practitioner - Nurse Practitioner 0749729382 Reassigns benefits to 3 organizations
I20240914000067 MD Practitioner - Nurse Practitioner 0749729382

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN1006184DCMDCritical Care Medicine Registered Nurse
NP1006184DCMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Breaking Silos in Medicine LLC CurrentSince Jun 23, 2024 Accepting new patients
District Healthcare Services, LLC Current Accepting new patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Jul 12, 2024 Accepting new patients

Locations

2478 Alabama Ave SE
Washington, DC 20020
Phone (202) 816-9448

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598

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": "1472515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1710433693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9497 PEP RALLY LN",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206033898",
            "telephone_number": "202-489-6118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 POST OFFICE RD UNIT 4A9497",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022726",
            "telephone_number": "202-489-6118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1221 Gallatin St NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200116915",
            "country_code": "US",
            "telephone_number": "202-489-6118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUTSUSHI",
        "first_name": "JANE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-30",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "DC",
            "license": "RN1006184",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DC",
            "license": "NP1006184",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "DC",
            "license": "RN1006184",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R166622",
            "primary": false
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "DC",
            "license": "RN1006184",
            "primary": false
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "DC",
            "license": "RN1006184",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "DC",
            "license": "NP1006184",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

Verify at the official NPI Registry.