Ebonique T Bennett, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

R233024 Issued in MD

Practice address

10 St. Patrick's Drive
Waldorf, MD 20603-4527

Phone

(301) 705-7870

Fax

(301) 705-7628

NPI assigned

Dec 11, 2011

Last updated

Aug 21, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Medstar Medical Group - Southern Maryland LLCGroup PAC ID 1355667056, 241 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

81.41 of 100Reported as group

Quality

61.45

Promoting interoperability

96

Improvement activities

40

Cost

79.91

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ebonique.bennettcrnp.p2@direct.msmg.nextgenshare.com

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

• Medstar Medical Group - Southern Maryland LLC

  dba MedStar Shah Medical Group, LLC

  • Internal Medicine Physician
  • Hollywood, MD
  • NPI 1831592211

  DC

  Medicare reassignment Care Compare group NPD
• Medstar Medical Group - Southern Maryland LLC

  dba MedStar Shah Medical Group LLC

  • Internal Medicine Physician
  • Fort Washington, MD
  • NPI 1649077678
  NPD
• Medstar Medical Group - Southern Maryland LLC

  • Ambulatory Surgical Clinic/Center
  • Waldorf, MD
  • NPI 1730571118
  NPD
• Medstar Southern Maryland Physicians, LLC

  dba Women's Health Center of Waldorf

  • Obstetrics & Gynecology Physician
  • White Plains, MD
  • NPI 1366644197
  NPD (past)

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

{
    "created_epoch": "1323561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1972871523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24035 THREE NOTCH RD",
            "city": "HOLLYWOOD",
            "state": "MD",
            "postal_code": "206364871",
            "telephone_number": "301-373-7900",
            "fax_number": "301-373-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 ST. PATRICK'S DRIVE",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034527",
            "telephone_number": "301-705-7870",
            "fax_number": "301-705-7628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "EBONIQUE",
        "middle_name": "T",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-11",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R233024",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "305905",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "840027000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ebony Belt
• Belvonae Health & Wellness LLC (MEtime Psychiatry & Co.)
• Camille Benedict, LCSW-C
• Melanie Benjamin, PHARMD.
• Wendell Bennett Hester
• Fanta Beretey
• Rachel Elizabeth Bernhardt, OTR/L
• Cindy Leigh Berres, RDH
• Terence Bertele, M.D.
• Tawfik Beshir

• Adult Health Nurse Practitioner in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Adult Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.