Individual provider Active NPI

Gboyega Haastrup

  • Home Health Aide
  • Upper Marlboro, MD
National Provider Identifier
1881408151
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Practice address
207 Harry S Truman Dr
Upper Marlboro, MD 20774-2053
Phone
(571) 866-3936
NPI assigned
Feb 5, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X Primary

Addresses

Primary practice location

207 Harry S Truman Dr
Upper Marlboro, MD 20774-2053

Mailing address

207 Harry S Truman Dr
Upper Marlboro, MD 20774-2053
Phone (571) 866-3936

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1738713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1881408151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 HARRY S TRUMAN DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207742053",
            "telephone_number": "571-866-3936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 HARRY S TRUMAN DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207742053",
            "telephone_number": "571-866-3936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAASTRUP",
        "first_name": "GBOYEGA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-02-05",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Marlboro, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.