| Innovative Behavioral Medicine LLC | |
|
801 Wayne Ave Ste G100 Silver Spring MD 20910-4493 | |
| (301) 615-8752 | |
| (240) 660-5460 |
| Full Name | Innovative Behavioral Medicine LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 801 Wayne Ave Ste G100, Silver Spring, Maryland |
| Authorized Official Name and Position | Christopher James Tundo (OWNER) |
| Authorized Official Contact | 2023229350 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Behavioral Medicine LLC 801 Wayne Ave Ste G100 Silver Spring MD 20910-4493 Ph: (202) 322-9350 | Innovative Behavioral Medicine LLC 801 Wayne Ave Ste G100 Silver Spring MD 20910-4493 Ph: (301) 615-8752 |
| NPI Number | 1043853740 |
|---|---|
| Provider Enumeration Date | 10/25/2019 |
| Last Update Date | 05/21/2026 |
| Certification Date | 05/21/2026 |
| Medicare PECOS PAC ID | 4284060302 |
|---|---|
| Medicare Enrollment ID | O20200210002140 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043853740 | NPI | - | NPPES |
| 778129600 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (NU) | Primary |
| 251S00000X | Community/behavioral Health | (NU) | Secondary |
| Provider Name | Christopher Tundo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316432172 PECOS PAC ID: 5193151215 Enrollment ID: I20200210002269 |
| Provider Name | Beata Barbara Gilbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427653864 PECOS PAC ID: 9032553219 Enrollment ID: I20260220001534 |
| Provider Name | Dorlin Bukirwa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174417679 PECOS PAC ID: 5799266425 Enrollment ID: I20260220002541 |
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