Ms Kenny Adeshola Amanze, CRNP-PHM in Upper Marlboro, MD

Ms Kenny Adeshola Amanze, CRNP-PHM is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Upper Marlboro, Maryland. Her current practice location is 2409 Baikal Loop, Upper Marlboro, Maryland. You can reach out to her office (for appointments etc.) via phone at (240) 643-5160.

Ms Kenny Adeshola Amanze is licensed to practice in Maryland (license number R207092) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1962168468.

Contact Information

	Ms Kenny Adeshola Amanze, CRNP-PHM
	2409 Baikal Loop, Upper Marlboro, MD 20774-7051
	(240) 643-5160
	Not Available

Map and Direction

Provider's Profile

Full Name	Ms Kenny Adeshola Amanze
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	2409 Baikal Loop, Upper Marlboro, Maryland
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1962168468
Provider Enumeration Date: 11/10/2021
Last Update Date: 11/10/2021

Medicare PECOS Information:

PECOS PAC ID: 4688062375
Enrollment ID: I20230520000086

Medical Identifiers

Medical identifiers for Ms Kenny Adeshola Amanze such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1962168468	NPI	-	NPPES
1043645344	Medicaid	MD
1083094056	Medicaid	MD

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	R207092 (Maryland)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ms Kenny Adeshola Amanze allows following entities to bill medicare on her behalf.

Entity Name	Activision Fidelity Psychiatric Mental Health Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1952008880 PECOS PAC ID: 6406212265 Enrollment ID: O20230520000076

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Kenny Adeshola Amanze is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Ms Kenny Adeshola Amanze, CRNP-PHM 2409 Baikal Loop, Upper Marlboro, MD 20774-7051 Ph: (240) 643-5160	Ms Kenny Adeshola Amanze, CRNP-PHM 2409 Baikal Loop, Upper Marlboro, MD 20774-7051 Ph: (240) 643-5160

Reviews and Comments

Nurse Practitioner Nurses in Upper Marlboro, MD

Mrs. Olayemi O Johnson, PMHNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2901 Valerian Ln, Upper Marlboro, MD 20774 Phone: 240-381-6576
Keonie Morrisey, PMHNP- BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5014 Forest Pines Dr, Upper Marlboro, MD 20772 Phone: 240-428-9191
Mrs. Shonte Renee Drakeford, APRN NP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 6610 Woodyard Road, Upper Marlboro, MD 20772 Phone: 240-899-1950
Kehinde Olatunji, CRNP, PMHNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 97 Capital Ct, Upper Marlboro, MD 20774 Phone: 301-618-0079
Frances Atuonah, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3912 Bishopmill Dr, Upper Marlboro, MD 20772 Phone: 202-710-6465
Mrs. Flora Bih Ndaka-nusta, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 600 Largo Rd Uppr Malboro, Upper Marlboro, MD 20774 Phone: 240-305-3696
Aileen Marie Raulin, RN CPNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 9692 Pennsylvania Ave, Upper Marlboro, MD 20772 Phone: 301-599-7300 Fax: 301-599-0476

Ms Kenny Adeshola Amanze, CRNP-PHM - Medicare Nurse Practitioner in Upper Marlboro, MD