Marcelline Ndonfack Enyeji
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Boyds, MD
NPI 1922800481 · NPPES record last updated Mar 26, 2025
Key facts
- NPI
- 1922800481
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- R234531 (MD)
- Practice address
- 21908 Ivy Leaf Dr
Boyds, MD 20841-4118 - Phone
- (240) 688-3498
- NPI assigned
- Mar 26, 2025
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
401 Hungerford Dr
Rockville, MD 20850-4192
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DC
- 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 |
|---|---|---|---|---|
| I20260625004751 | DC | Practitioner - Nurse Practitioner | 5294208617 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R234531 | MD | MD | Psychiatric/Mental Health Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | R234531 | MD | Yes |
Addresses
Primary practice location
21908 Ivy Leaf Dr
Boyds, MD 20841-4118
Mailing address
21908 Ivy Leaf Dr
Boyds, MD 20841-4118
Phone (240) 688-3498
Other providers in Boyds, MD
- Cultivate Rehabiliation Services, LLC
- Lindsay M David
- Diagnostic Imaging Inc
- Dialysis Care LLC
- Pamela June Dixon Mitchell
- Erin L. Koch and Associates
- Joan Furlani
- Ana-Alicia Garcia
- Jerilyn Kay Glass
- Gabrielle Liann Go
All providers in Boyds, 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 Mar 26, 2025. 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.