NPIMap

Organization Active NPI

Graceway Health Care LLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Ellicott City, MD
National Provider Identifier
1134076359
Registry record updated Mar 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
GRACEWAY HEALTH CARE LLC
Practice address
10259 Cabery Rd
Ellicott City, MD 21042-1605
Phone
(410) 870-9380
NPI assigned
Mar 16, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2026

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

Authorized official

Name
Addisu M. Temesgen, MD
Title
MD
Phone
(410) 435-9073

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X Primary

Addresses

Primary practice location

10259 Cabery Rd
Ellicott City, MD 21042-1605

Mailing address

115 E Melrose Ave
Baltimore, MD 21212-2945
Phone (410) 435-9073

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220909001488 MD Part B Supplier - Clinic/Group Practice 9537544648 Receives reassigned benefits from 16 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Elkton, MD; Ellicott City, MD; Timonium, MD; Towson, MD; Bel Air, MD; Catonsville, MD; Annapolis, MD; Baltimore, MD
O20221005002859 DC Part B Supplier - Clinic/Group Practice 9537544648 Receives reassigned benefits from 11 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clinton, MD

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Graceway Health Care LLC19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1773619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774569600000",
    "number": "1134076359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 E MELROSE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212122945",
            "telephone_number": "410-435-9073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10259 CABERY RD",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210421605",
            "telephone_number": "410-870-9380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACEWAY HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-16",
        "last_updated": "2026-03-27",
        "certification_date": "2026-03-27",
        "status": "A",
        "authorized_official_last_name": "TEMESGEN",
        "authorized_official_first_name": "ADDISU",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "410-435-9073",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.