Individual provider Active NPI

Abimbola A Runsewe, DNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Windsor Mill, MD
National Provider Identifier
1760789507
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R176584 Issued in MD
Practice address
3605 Milford Mill Rd
Windsor Mill, MD 21244-3329
Phone
(443) 272-7858
Fax
(443) 405-7237
NPI assigned
Feb 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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 R176584 MD Primary

Addresses

Primary practice location

3605 Milford Mill Rd
Windsor Mill, MD 21244-3329

Mailing address

3605 Milford Mill Rd
Windsor Mill, MD 21244-3329
Phone (443) 272-7858

Other practice location 1

610 Professional Dr
Gaithersburg, MD 20879-3413
Phone (240) 683-6202

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
I20110419000140 MD Practitioner - Nurse Practitioner 8729262746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3608 Milford Mill Rd
Windsor Mill, MD 21244-3328
Phone (443) 272-7858

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R176584MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Reach Behavioral Health LLC Psychiatric/Mental Health CurrentSince Nov 22, 2022 Accepting new patients
A Broad Place LLC Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Green Ridge Behavioral Health, LLC PastSince Nov 1, 2019 Accepting new patients

Locations

3605 Milford Mill Rd
Windsor Mill, MD 21244

3608 Milford Mill Rd
Windsor Mill, MD 21244
Phone (443) 272-7858

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10109/brand/1/csg/1/fhir/r4

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1297641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1760789507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3605 MILFORD MILL RD",
            "city": "WINDSOR MILL",
            "state": "MD",
            "postal_code": "212443329",
            "telephone_number": "443-272-7858",
            "fax_number": "443-405-7237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3605 MILFORD MILL RD",
            "city": "WINDSOR MILL",
            "state": "MD",
            "postal_code": "212443329",
            "telephone_number": "443-272-7858",
            "fax_number": "443-405-7237"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "610 Professional Dr",
            "address_purpose": "LOCATION",
            "city": "Gaithersburg",
            "state": "MD",
            "postal_code": "208793413",
            "country_code": "US",
            "telephone_number": "240-683-6202",
            "fax_number": "240-683-6203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUNSEWE",
        "first_name": "ABIMBOLA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DNP, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-14",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R176584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor Mill, MD

Sources for this page

Verify at the official NPI Registry.