Active NPI
Mary Tessie Thullah Bangura, DNP-PMHNP
- Gerontology Nurse Practitioner
- Washington, DC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- NP1009163
- Practice address
- 2603 Hamlin St NE
Washington, DC 20018-2530 - Phone
- (202) 730-6559
- NPI assigned
- Aug 20, 2021
- Last updated
- Jul 14, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | R161437 | MD | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | NP1009163 | DC | |
| Gerontology Nurse Practitioner | 363LG0600X | NP1009163 | DC | Primary |
Addresses
Primary practice location
2603 Hamlin St NE
Washington, DC 20018-2530
Mailing address
5055 Seminary Rd Apt 239
Alexandria, VA 22311-2004
Phone (202) 730-6559
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12312 Quail Woods Dr
Germantown, MD 20874-1542
Phone (240) 241-8408
5643 Scott Ridge PL
Frederick, MD 21704-6755
Phone (240) 421-8408
650 Pennsylvania Ave SE
Suite 330
Washington, DC 20003-4397
Phone (202) 610-9570
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R161437 | MD | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elevate Health Solutions, LLC | Psychiatric/Mental Health | Current | Accepting new patients |
| Comprehensive Mental & Relaxation Clinic Inc | Current | Accepting new patients | |
| Elevate Health Solutions, LLC | Current | Accepting new patients | |
| RB Angels Haven Health Center PLLC | Gerontology | Current | Accepting new patients |
Locations
650 Pennsylvania Ave SE
Ste 330
Washington, DC 20003
Phone (202) 610-9570
121 Congressional Ln
Ste 316
Rockville, MD 20852
Phone (240) 221-3116
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.
-
- Gerontology Nurse Practitioner
- Washington, DC
- NPI 1669318564
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Germantown, MD
- NPI 1427890748
DC
-
- Internal Medicine Physician
- Washington, DC
- NPI 1861690539
-
- Internal Medicine Physician
- Washington, DC
- NPI 1437974961
-
- Internal Medicine Physician
- Rockville, MD
- NPI 1003601006
Psychiatric/Mental Health
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Cedar Hill Regional Medical Center
- General Acute Care Hospital
- Washington, DC
- NPI 1285492892
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783987200000",
"number": "1740956531",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5055 SEMINARY RD APT 239",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223112004",
"telephone_number": "202-730-6559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2603 HAMLIN ST NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200182530",
"telephone_number": "202-730-6559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THULLAH BANGURA",
"first_name": "MARY",
"middle_name": "TESSIE",
"credential": "DNP-PMHNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-20",
"last_updated": "2026-07-14",
"certification_date": "2026-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "MD",
"license": "R161437",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "DC",
"license": "NP1009163",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "DC",
"license": "NP1009163",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Washington, DC
- Karen R Threlkel, N.D.
- Thrive DC Healthcare Services LLC
- Thrive Neuropsych and Therapy Services LLC
- Thrive Residential Services LLC (Thrive)
- Thrive: Counseling and Psychological Services
- Thurgood Marshall Academy PCHS
- Purvis Thurman Jr.
- Alexis Maria Thurmond, MD
- Andre Lamont Thurmond
- Jessica Jean Thurn, AG-ACNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.