Bernard Amalimeh
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Middle River, MD
NPI 1760194112 · NPPES record last updated Feb 2, 2023
Key facts
- NPI
- 1760194112
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- R254301 (MD)
- Practice address
- 10655 Wennington St
Middle River, MD 21220-3151 - Phone
- (618) 558-7165
- NPI assigned
- Dec 16, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Baltimore Medical System, Inc.
Valor Health Inc
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
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230519001679 | MD | Practitioner - Nurse Practitioner | 3274999008 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R254301 | MD | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valor Health Inc | Psychiatric/Mental Health | Current |
Accepting new patients |
| Baltimore Medical System, Inc. | Current |
Accepting new patients |
Locations
7845 Oakwood Rd
Ste 205
Glen Burnie, MD 21061
Phone (240) 223-0633
1000 Stewart Ave
Glen Burnie, MD 21061
Interoperability endpoints
- bernard.amalimeh.1@32712.direct.athenahealth.com
- bernard.amalimeh.p1@direct.bmsi.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | R254301 | MD | Yes |
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
Other providers in Middle River, MD
- Ibijoke Titilayo Agbem
- Funmilayo Elizabeth Ajala
- Olubimpe Beatrice Akinyelure
- Victor A Akinyemi
- Akinwumi Alao
- Amazin Recovery Treatment Services
- Ambassadors Healthcare Services Inc.
- Americoast Maryland LLC
- Ameshicares Inc
- Michaeleen Kennedy Anderson
All providers in Middle River, MD · Psychiatric/Mental Health Nurse Practitioner in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 2, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.