EVERGREEN HEALTHCARE CLINIC LIMITED LIABILITY COMPANY
NPI 1659162402
Nurse Practitioner - Psychiatric/Mental Health in Baltimore, MD
About Evergreen Healthcare Clinic Limited Liability Company NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EVERGREEN HEALTHCARE CLINIC LIMITED LIABILITY COMPANY (NPI 1659162402) is a healthcare organization registered as a psychiatric/mental health in Baltimore, Maryland and active in the NPI registry since May 2025. The organization holds a CLIA Waiver certificate valid through August 10, 2028 and lists Yvette Ledjo, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Evergreen Healthcare Clinic Limited Liability Company is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Evergreen Healthcare Clinic Limited Liability Company, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 21D2348743
Evergreen Healthcare LLC · Baltimore, MDFrequently 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 Evergreen Healthcare Clinic Limited Liability Company's NPI number?
The NPI number for Evergreen Healthcare Clinic Limited Liability Company is 1659162402. It was assigned to this organization in the NPPES registry on May 13, 2025.
Where is Evergreen Healthcare Clinic Limited Liability Company located?
Evergreen Healthcare Clinic Limited Liability Company is located at 300 N Charles St Ste D, Baltimore, MD 21201. The listed phone number is (240) 644-5570.
What is Evergreen Healthcare Clinic Limited Liability Company's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Evergreen Healthcare Clinic Limited Liability Company enrolled in Medicare?
Yes. Evergreen Healthcare Clinic Limited Liability Company is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Evergreen Healthcare Clinic Limited Liability Company?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Evergreen Healthcare Clinic Limited Liability Company. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Evergreen Healthcare Clinic Limited Liability Company hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 21D2348743) is associated with this NPI, valid through August 10, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Evergreen Healthcare Clinic Limited Liability Company was last updated on July 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.
# Evergreen Healthcare Clinic Limited Liability Company · NPI 1659162402
Psychiatric/Mental Health organization in Baltimore, Maryland. Organization record, active in the CMS NPPES registry since May 13, 2025.
## Identity
- **NPI:** 1659162402 (Entity type: Organization)
- **Enumerated:** May 13, 2025
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Yvette Ledjo, CEO
## Practice location
- **Address:** 300 N CHARLES ST STE D, Baltimore, MD 21201-4305
- **Phone:** (240) 644-5570
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 7, 2026
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1659162402) · Data from the CMS NPPES public registry.