Individual provider Active NPI

Vasty Adade

  • Psychiatric/Mental Health Nurse Practitioner
  • Parkville, MD
National Provider Identifier
1760058069
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R228737 Issued in MD
Practice address
8116 Harford Rd Ste B
Parkville, MD 21234-5761
Phone
(410) 779-9175
NPI assigned
May 28, 2021
Last updated
Jul 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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 R228737 MD Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X R228737 MD

Addresses

Primary practice location

8116 Harford Rd Ste B
Parkville, MD 21234-5761

Mailing address

511 Foster Branch Rd
Joppa, MD 21085-4203
Phone (443) 668-6819

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
I20230323003114 MD Practitioner - Nurse Practitioner 9032583521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peace Healthcare IncGroup PAC ID 7517253727, 2 clinicians

Practice addresses (Care Compare)

8203 Harford Rd
Parkville, MD 21234-5888
Phone (410) 779-9175

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R228737MDMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Peace Healthcare Inc CurrentSince Sep 21, 2024 Accepting new patients

Locations

8116 Harford Rd
Ste B
Parkville, MD 21234
Phone (410) 779-9175

8203 Harford Rd
Parkville, MD 21234
Phone (410) 779-9175

Organizations & group practices 1

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": "1622160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1760058069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 FOSTER BRANCH RD",
            "city": "JOPPA",
            "state": "MD",
            "postal_code": "210854203",
            "telephone_number": "443-668-6819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8116 HARFORD RD STE B",
            "city": "PARKVILLE",
            "state": "MD",
            "postal_code": "212345761",
            "telephone_number": "410-779-9175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADADE",
        "first_name": "VASTY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-28",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R228737",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R228737",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkville, MD

Sources for this page

Verify at the official NPI Registry.