DWAYNE OMAR ENNIS PMHNP-BC
NPI 1700607835
Nurse Practitioner - Psychiatric/Mental Health in La Plata, MD
About Dwayne Omar Ennis Pmhnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DWAYNE OMAR ENNIS PMHNP-BC (NPI 1700607835) is an individual psychiatric/mental health provider in La Plata, Maryland, licensed in Maryland (R173805) and active in the NPI registry since October 2024. He is enrolled in Medicare PECOS, maintains a secondary practice location in Silver Spring, and is a graduate of Other (2014).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dwayne Omar Ennis Pmhnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Dwayne Ennis reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Barstow, MD 20610
- Reassigned Medicare billing, Maryland enrollment
- 25 clinicians in this Medicare group
Silver Spring, MD 20910
- Reassigned Medicare billing, District of Columbia and Maryland enrollments
- 128 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 20646 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 7
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
LA PLATA, MD 20646
LA PLATA, MD 20646
LA PLATA, MD 20646
LA PLATA, MD 20646
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 Dwayne Ennis's NPI number?
The NPI number for Dwayne Ennis is 1700607835. It was assigned to this individual provider in the NPPES registry on October 21, 2024.
Where is Dwayne Ennis located?
Dwayne Ennis practices at 1014 Washington Ave, La Plata, MD 20646. The listed phone number is (917) 560-5145.
What is Dwayne Ennis's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Dwayne Ennis enrolled in Medicare?
Yes. Dwayne Ennis is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Dwayne Ennis's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Dwayne Ennis reassigns Medicare benefits to 2 organizations: Calvert County Health Department (Barstow, MD) and Axis Healthcare Group (Silver Spring, MD). Each 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 Dwayne Ennis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Dwayne Ennis was last updated on February 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.
# Dwayne Omar Ennis, PMHNP-BC · NPI 1700607835
Psychiatric/Mental Health physician in La Plata, Maryland. Individual provider, active in the CMS NPPES registry since October 21, 2024.
## Identity
- **NPI:** 1700607835 (Entity type: Individual)
- **Enumerated:** October 21, 2024
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** R173805 (Maryland)
- **Sole proprietor:** No
## Practice location
- **Address:** 1014 WASHINGTON AVE, La Plata, MD 20646-4228
- **Phone:** (917) 560-5145
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Calvert County Health Department (NPI 1912355637, Barstow, MD); Axis Healthcare Group (NPI 1326295098, Silver Spring, MD) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2014
## Record status
- **NPPES last updated:** February 6, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1700607835) · Data from the CMS NPPES public registry.