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OUTREACH RECOVERY II, LLC
NPI 1215593785
Preventive Medicine - Addiction Medicine in Glen Burnie, MD

Active since May 10, 2019
1410 CRAIN HWY N STE 7B, GLEN BURNIE, MD 21061(561) 502-3978 Get Directions Write a Review

NPPES record last updated: July 31, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 31, 2024, Mar 4, 2021, Jan 2, 2020 and 1 more (4 updates tracked since 2019).

About Outreach Recovery Ii, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OUTREACH RECOVERY II, LLC (NPI 1215593785) is a healthcare organization registered as an addiction medicine in Glen Burnie, Maryland and active in the NPI registry since May 2019. The organization lists Isiah Coles, Coo, as its authorized official.

NPPES Registry Identity

NPI1215593785
Entity TypeOrganization
Primary Taxonomy2083A0300X
Legal Business NameOUTREACH RECOVERY II, LLC
Location Address1410 CRAIN HWY N STE 7BGlen Burnie, MD 21061-9304
Mailing Address14205 Park Center Dr # 201202Laurel, MD 20707-5246 · (410) 800-4466
Phone(561) 502-3978
Organization SubpartNo
Authorized OfficialIsiah ColesCoo · (561) 502-3978
Enumeration DateMay 10, 2019
Last NPPES UpdateJuly 31, 20244 updates tracked since enumeration
NPPES CertifiedJuly 31, 2024
✔ NPI 1215593785 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPreventive Medicine · Addiction MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2083A0300X
Definition
A physician engaged in the subspecialty practice of Addiction Medicine who specializes in the prevention, evaluation, diagnosis, treatment, and recovery of persons with the disease of addiction.
Also ListedRegistered Nurse · Psychiatric/Mental Health, AdultTaxonomy 163WP0809X
Also ListedFamily MedicineTaxonomy 207Q00000X
1410 CRAIN HWY N STE 7B, Glen Burnie, MD 21061
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Other Identifiers 1

Medicaid100089627MD

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Outreach Recovery Ii, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

10

Medicare enrollment records show 10 clinicians reassign Medicare billing to Outreach Recovery II, LLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 5

Nurse Practitioner5
Family Practice2
Internal Medicine1
Mental Health Counselor1
Physical Medicine and Rehabilitation1

Clinicians, nearest first (10)

Gregory Ross, M.D.
Internal Medicine
NPI 1669516118
222 N CHARLES ST STE 101B
Baltimore, MD 21201
(410) 685-8665
✔ PECOS✔ Accepts Medicare7.3 mi
Brooke Stanley, CRNP
Nurse Practitioner
NPI 1619768728
588 BELLERIVE DR STE 1D
Annapolis, MD 21409
(443) 949-5322
✔ PECOS✔ Accepts Medicare13 mi
Kondi Walters-Smith, CRNP
Nurse Practitioner
NPI 1780190595
12114 BLUE FLAG WAY
Columbia, MD 21044
(301) 741-0307
✔ PECOS✔ Accepts Medicare15 mi
Jon Thomas, LCPC
Mental Health Counselor
NPI 1356613392
3509 SHEFFIELD MANOR TER APT 201
Silver Spring, MD 20904
(301) 857-2937
✔ PECOS✔ Accepts Medicare19 mi
Uchechukwu Ifeji
Nurse Practitioner
NPI 1043736846
11120 NEW HAMPSHIRE AVE STE 501
Silver Spring, MD 20904
(240) 437-4602
✔ PECOS✔ Accepts Medicare23 mi
Asong Benanzea Fontem, NP
Nurse Practitioner
NPI 1578105326
3300 GALLOWS RD
Falls Church, VA 22042
(703) 776-4001
✔ PECOS✔ Accepts Medicare40 mi
Keith Radbill, DO
Family Practice
NPI 1861557795
602 W. MAPLE AVE.
Merchantville, NJ 08109
(856) 375-1500
✔ PECOS✔ Accepts Medicare98 mi
Reina Perdew, FNP-C
Nurse Practitioner
NPI 1710687918
72 GREENE ST
Cumberland, MD 21502
(667) 280-7066
✔ PECOS✔ Accepts Medicare119 mi
Ehsan Abdeshahian, MD
Physical Medicine and Rehabilitation
NPI 1871844720
67 WALL ST APT 10F
New York, NY 10005
(405) 306-0384
✔ PECOS✔ Accepts Medicare174 mi
Kristopher Rai
Family Practice
NPI 1932588449
500 KIRTS BLVD STE 200
Troy, MI 48084
(248) 824-6060
✔ PECOS✔ Accepts Medicare414 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Outreach Recovery II, LLC's NPI number?

The NPI number for Outreach Recovery II, LLC is 1215593785. It was assigned to this organization in the NPPES registry on May 10, 2019.

Where is Outreach Recovery II, LLC located?

Outreach Recovery II, LLC is located at 1410 Crain Hwy N Ste 7B, Glen Burnie, MD 21061. The listed phone number is (561) 502-3978.

What is Outreach Recovery II, LLC's specialty?

The primary specialty registered for this NPI is Preventive Medicine, specializing in Addiction Medicine, with taxonomy code 2083A0300X.

Is Outreach Recovery II, LLC enrolled in Medicare?

Yes. Outreach Recovery II, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Outreach Recovery II, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 10 clinicians in 5 Medicare specialties reassign their Medicare billing to Outreach Recovery II, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (5), Family Practice (2) and Internal Medicine (1). Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Outreach Recovery II, LLC was last updated on July 31, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.