Individual provider Active NPI

Bernard Amalimeh

  • Psychiatric/Mental Health Nurse Practitioner
  • Middle River, MD
National Provider Identifier
1760194112
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R254301 Issued in MD
Practice address
10655 Wennington St
Middle River, MD 21220-3151
Phone
(618) 558-7165
NPI assigned
Dec 16, 2022
Last updated
Feb 2, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R254301 MD Primary

Addresses

Primary practice location

10655 Wennington St
Middle River, MD 21220-3151

Mailing address

10655 Wennington St
Middle River, MD 21220-3151
Phone (618) 558-7165

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
I20230519001679 MD Practitioner - Nurse Practitioner 3274999008 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baltimore Medical System, Inc.Group PAC ID 5395653455, 86 clinicians
Valor Health IncGroup PAC ID 6709206337, 5 clinicians

Practice addresses (Care Compare)

5525 Eastern Ave
Suite 301
Baltimore, MD 21224-2796
Phone (410) 558-4804

7845 Oakwood Rd
Suite 205
Glen Burnie, MD 21061-4257
Phone (240) 223-0633

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R254301MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baltimore Medical System, Inc. CurrentSince Jan 9, 2024 Accepting new patients
Valor Health Inc Psychiatric/Mental Health CurrentSince Feb 1, 2023 Accepting new patients

Locations

1000 Stewart Ave
Glen Burnie, MD 21061

7845 Oakwood Rd
Ste 205
Glen Burnie, MD 21061
Phone (240) 223-0633

Interoperability endpoints

  • Direct secure messaging: bernard.amalimeh.1@32712.direct.athenahealth.com
  • Direct secure messaging: bernard.amalimeh.p1@direct.bmsi.nextgenshare.com

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": "1671148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1760194112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10655 WENNINGTON ST",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212203151",
            "telephone_number": "618-558-7165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10655 WENNINGTON ST",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212203151",
            "telephone_number": "618-558-7165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMALIMEH",
        "first_name": "BERNARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-16",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R254301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middle River, MD

Sources for this page

Verify at the official NPI Registry.