Osereme Nora Agboifo, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R197691 Issued in MD

Practice address

200 Ejoppa Rd Suite 106
Townson, MD 21286

Phone

(410) 337-0007

NPI assigned

Oct 9, 2020

Last updated

Oct 9, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, 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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

White Marsh Psychiatric Associates, LLCGroup PAC ID 3072681105, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Royalty Health Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Odenton, MD
  • NPI 1205546488
  Medicare reassignment NPD Authorized official
• White Marsh Psychiatric Associates, LLC

  • Psychiatry Physician
  • Baltimore, MD
  • NPI 1043466147
  Medicare reassignment Care Compare group NPD
• Excellent Healthcare & Psychiatric Rehabilitation Program Services Inc

  • Mental Health Counselor
  • Baltimore, MD
  • NPI 1356937080
  NPD
• Excellent Healthcare & Psychiatric Rehabilitation Program Services Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
  • NPI 1942883699
  NPD
• G & E Behavioral Health Services, LLC

  • Psychiatry Physician
  • Baltimore, MD
  • NPI 1316554793
  NPD
• Newage Psych

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Parkville, MD
  • NPI 1316518376
  NPD
• Newage Psych

  • Community/Behavioral Health Agency
  • Parkville, MD
  • NPI 1548831506
  NPD
• G & E Behavioral Health Services, LLC

  • Primary Care Nurse Practitioner
  • Baltimore, MD
  • NPI 1609468933
  NPD (past)

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

{
    "created_epoch": "1602201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1750989042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1422 SERVICE BERRY WAY",
            "city": "ODENTON",
            "state": "MD",
            "postal_code": "211136052",
            "telephone_number": "832-606-9675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 EJOPPA RD SUITE 106",
            "city": "TOWNSON",
            "state": "MD",
            "postal_code": "21286",
            "telephone_number": "410-337-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGBOIFO",
        "first_name": "OSEREME",
        "middle_name": "NORA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-09",
        "last_updated": "2020-10-09",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R197691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rabiah Aslam Ansari
• Victoria L Barnett
• Ann Liz Raulachan

• Psychiatric/Mental Health Nurse Practitioner in Townson, MD
• Providers in Townson, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; 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.

Verify at the official NPI Registry.