MATTDIVINE HEALTHCARE AND WELLNESS SERVICES LLC
NPI 1902530702
Nurse Practitioner - Psychiatric/Mental Health in Laurel, MD
About Mattdivine Healthcare And Wellness Services Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MATTDIVINE HEALTHCARE AND WELLNESS SERVICES LLC (NPI 1902530702) is a healthcare organization registered as a psychiatric/mental health in Laurel, Maryland and active in the NPI registry since July 2022. The organization lists Ogochukwu Enyi, 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)
Mattdivine Healthcare And Wellness Services Llc 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 Mattdivine Healthcare And Wellness Services LLC, 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.
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 Mattdivine Healthcare And Wellness Services LLC's NPI number?
The NPI number for Mattdivine Healthcare And Wellness Services LLC is 1902530702. It was assigned to this organization in the NPPES registry on July 15, 2022.
Where is Mattdivine Healthcare And Wellness Services LLC located?
Mattdivine Healthcare And Wellness Services LLC is located at 8506 Snowden Loop, Laurel, MD 20708. The listed phone number is (240) 501-0232.
What is Mattdivine Healthcare And Wellness Services LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Mattdivine Healthcare And Wellness Services LLC enrolled in Medicare?
Yes. Mattdivine Healthcare And Wellness Services LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Mattdivine Healthcare And Wellness Services LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Mattdivine Healthcare And Wellness Services 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Mattdivine Healthcare And Wellness Services LLC was last updated on July 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Mattdivine Healthcare And Wellness Services Llc · NPI 1902530702
Psychiatric/Mental Health organization in Laurel, Maryland. Organization record, active in the CMS NPPES registry since July 15, 2022.
## Identity
- **NPI:** 1902530702 (Entity type: Organization)
- **Enumerated:** July 15, 2022
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Ogochukwu Enyi, CEO
## Practice location
- **Address:** 8506 SNOWDEN LOOP, Laurel, MD 20708-2360
- **Phone:** (240) 501-0232
## 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 15, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1902530702) · Data from the CMS NPPES public registry.