Caroline Ibijemilusi

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

R160656 Issued in MD

Practice address

9470 Annapolis Rd Ste 402
Lanham, MD 20706-3059

Phone

(240) 770-6689

Fax

(240) 667-2190

NPI assigned

Sep 22, 2018

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

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: caroline.ibijemilusi@pchcl-md.direct.office.nextgen.com

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.

• Patient Centered Health Care LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lanham, MD
  • NPI 1952113060
  NPD (past) Authorized official

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

{
    "created_epoch": "1537574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1982188231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9470 ANNAPOLIS RD STE 402",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063059",
            "telephone_number": "240-770-6689",
            "fax_number": "240-667-2190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9470 ANNAPOLIS RD STE 402",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063059",
            "telephone_number": "240-770-6689",
            "fax_number": "240-667-2190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBIJEMILUSI",
        "first_name": "CAROLINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-22",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R160696",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MD",
            "license": "R160656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Azher Hussain, MD
• Waseem Hussain, MD
• Saifudin Abdella Hussein, M.D
• Patrick Hyousse
• I-Focused, Inc.
• Olufunso Ibrahim, O.D.
• Mary Grace Lorenzana Ico
• Oboehi Comfort Idehai
• Abimbola Oluwakemi Idowu, HHA
• Adebayo Adeyemi Idowu

• Primary Care Nurse Practitioner in Lanham, MD
• Providers in Lanham, MD by specialty
• Primary Care Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2025; 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.