Individual provider Active NPI

Jessica Ofosua, NP

  • Family Nurse Practitioner
  • Brandywine, MD
National Provider Identifier
1801515788
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R223309 Issued in MD
Practice address
7450 Albert Rd FL 2
Brandywine, MD 20613-3035
Phone
(301) 888-2233
Fax
(301) 888-9133
NPI assigned
Aug 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R223309 MD Primary

Addresses

Primary practice location

7450 Albert Rd FL 2
Brandywine, MD 20613-3035

Mailing address

3222 Shadow Park Dr
Laurel, MD 20724-2929

Other identifiers 1

IdentifierTypeStateIssuer
880425700MedicaidMD

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230220001278 MD Practitioner - Nurse Practitioner 3375915473 Reassigns benefits to 1 organization
I20230221003094 DC Practitioner - Nurse Practitioner 3375915473 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R223309MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Baden Medical Service Incorporated CurrentSince Nov 9, 2022 Accepting new patients
Greater Baden Medical Service Incorporated Family Medicine CurrentSince Nov 9, 2022 Accepting new patients
Greater Baden Medical Service Incorporated Past Accepting new patients

Locations

7450 Albert Rd
Fl 2
Brandywine, MD 20613

7450 Albert Rd
Ste 3
Brandywine, MD 20613

7450 Albert Rd
Fl 3
Brandywine, MD 20613
Phone (301) 599-0460

8030 Matthews Rd
#105107
Bryans Road, MD 20616

8030 Matthews Rd
Ste 105107
Bryans Road, MD 20616

1442 Addison Rd S
Capitol Heights, MD 20743
Phone (301) 324-1500

1458 Addison Rd S
Capitol Heights, MD 20743
Phone (301) 324-1500

6 Garrett Ave
La Plata, MD 20646
Phone (301) 539-5100

23140 Moakley St
Ste 4
Leonardtown, MD 20650
Phone (301) 997-1029

21729 Great Mills Rd
Ste C
Lexington Park, MD 20653
Phone (240) 895-8396

6196 Oxon Hill Rd
Ste 540
Oxon Hill, MD 20745
Phone (301) 686-1665

Interoperability endpoints

  • Direct secure messaging: jessica.ofosua@gbms.eclinicaldirectplus.com

Organizations & group practices 3

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": "1661299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1801515788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3222 SHADOW PARK DR",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207242929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7450 ALBERT RD FL 2",
            "city": "BRANDYWINE",
            "state": "MD",
            "postal_code": "206133035",
            "telephone_number": "301-888-2233",
            "fax_number": "301-888-9133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OFOSUA",
        "first_name": "JESSICA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-24",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R223309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "880425700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandywine, MD

Sources for this page

Verify at the official NPI Registry.