Individual provider Active NPI

Beatrice Mouga Kouemou, CRNP

  • Family Medicine Physician
  • Baltimore, MD
National Provider Identifier
1821639634
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R210351 Issued in MD
Practice address
1040 Park Ave Ste 200
Baltimore, MD 21201-5634
Phone
(667) 400-0223
Fax
(443) 738-0301
NPI assigned
Oct 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X F346954-01 NY
Family Medicine Physician 207Q00000X R210351 MD Primary

Addresses

Primary practice location

1040 Park Ave Ste 200
Baltimore, MD 21201-5634

Mailing address

1040 Park Ave Ste 200
Baltimore, MD 21201-5634
Phone (667) 400-0223

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
I20250617003611 MD Practitioner - Nurse Practitioner 8022529916 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R210351MDMDFamily Medicine Physician
F346954-01NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baltimore Medical System, Inc. CurrentSince Aug 1, 2025 Accepting new patients
Baltimore Medical System, Inc. CurrentSince Aug 1, 2025 Accepting new patients

Locations

1040 Park Ave
Ste 200
Baltimore, MD 21201
Phone (443) 738-0300

1000 Stewart Ave
Glen Burnie, MD 21061

Interoperability endpoints

  • Direct secure messaging: beatrice.kouemou.p1@direct.mhhc.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1569974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1821639634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 PARK AVE STE 200",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212015634",
            "telephone_number": "667-400-0223",
            "fax_number": "443-738-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 PARK AVE STE 200",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212015634",
            "telephone_number": "667-400-0223",
            "fax_number": "443-738-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUEMOU",
        "first_name": "BEATRICE",
        "middle_name": "MOUGA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-02",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "F346954-01",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "R210351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.