Individual provider Active NPI

Kidist Worku

  • Family Nurse Practitioner
  • Owings Mills, MD
National Provider Identifier
1093341992
Registry record updated Mar 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R181283 Issued in MD
Practice address
1 Williams CT
Owings Mills, MD 21117-4889
Phone
(410) 908-5354
NPI assigned
Mar 23, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R181283 MD Primary

Addresses

Primary practice location

1 Williams CT
Owings Mills, MD 21117-4889

Mailing address

1 Williams CT
Owings Mills, MD 21117-4889
Phone (410) 908-5354

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200619000483 MD Practitioner - Nurse Practitioner 1355763301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

9103 Franklin Square Dr
Baltimore, MD 21237-3900
Phone (443) 777-2663

Hospital & facility affiliations

  • Medstar Franklin Square Medical Center Hospital, Rosedale, MD, CCN 210015
  • Medstar Good Samaritan Hospital Hospital, Baltimore, MD, CCN 210056

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Mar 1, 2023 Accepting new patients
Medstar Medical Group II LLC Past Accepting new patients

Locations

5601 Loch Raven Blvd
Baltimore, MD 21239
Phone (443) 444-4714

5601 Loch Raven Blvd
Ste 103
Baltimore, MD 21239
Phone (443) 444-3991

1406 Crain Hwy S
Ste 106
Glen Burnie, MD 21061
Phone (410) 768-6440

9103 Franklin Square Dr
Rosedale, MD 21237
Phone (443) 777-7147

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584921600000",
    "number": "1093341992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WILLIAMS CT",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211174889",
            "telephone_number": "410-908-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WILLIAMS CT",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211174889",
            "telephone_number": "410-908-5354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORKU",
        "first_name": "KIDIST",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-23",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R181283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owings Mills, MD

Sources for this page

Verify at the official NPI Registry.