MEDHAVEN LLC
NPI 1710618152
Clinic/Center - Health Service in Glen Burnie, MD
About Medhaven Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MEDHAVEN LLC (NPI 1710618152) is a healthcare organization registered as a health service in Glen Burnie, Maryland and active in the NPI registry since June 2022. The organization holds a CLIA Waiver certificate valid through September 18, 2027 and lists Oluwakemi F Balogun, Crnp, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Other Names 1
Other Identifiers 1
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)
Medhaven Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Medhaven LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
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 21D2290002
Medhaven Health · Glen Burnie, 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 Medhaven Health LLC's NPI number?
The NPI number for Medhaven Health LLC is 1710618152. It was assigned to this organization in the NPPES registry on June 17, 2022. The provider is doing business as Medhaven LLC.
Where is Medhaven Health LLC located?
Medhaven Health LLC is located at 7310 Ritchie Hwy Ste 519, Glen Burnie, MD 21061. The listed phone number is (240) 515-6550.
What is Medhaven Health LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Health Service, with taxonomy code 261QH0100X.
Is Medhaven Health LLC enrolled in Medicare?
Yes. Medhaven Health LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Medhaven Health LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Medhaven Health 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. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Medhaven Health LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 21D2290002) is associated with this NPI, valid through September 18, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Medhaven Health LLC was last updated on November 27, 2023. 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.
# Medhaven Llc · NPI 1710618152
Health Service organization in Glen Burnie, Maryland. Organization record, active in the CMS NPPES registry since June 17, 2022.
## Identity
- **NPI:** 1710618152 (Entity type: Organization)
- **Enumerated:** June 17, 2022
- **Primary specialty:** Clinic/Center - Health Service · taxonomy 261QH0100X
- **Legal business name:** Medhaven Health Llc
- **Organization subpart:** No
- **Authorized official:** Oluwakemi Balogun, CRNP
## Practice location
- **Address:** 7310 RITCHIE HWY STE 519, Glen Burnie, MD 21061-3099
- **Phone:** (240) 515-6550
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 27, 2023
- **Other identifiers:** Medicaid 1962963389 (MD)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1710618152) · Data from the CMS NPPES public registry.