Individual provider Active NPI

Hawi Assefa Keno

  • Medical Physician Assistant
  • Hyattsville, MD
National Provider Identifier
1154046449
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
6401 America Blvd
Hyattsville, MD 20782-2357
Phone
(855) 910-3278
NPI assigned
Oct 10, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

6401 America Blvd
Hyattsville, MD 20782-2357

Mailing address

6401 America Blvd
Hyattsville, MD 20782-2357

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230719003963 DC Practitioner - Physician Assistant 5597125799 Reassigns benefits to 1 organization
I20230720000375 MD Practitioner - Physician Assistant 5597125799 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Drexel University College of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Urgent Care LLCGroup PAC ID 9335303155, shared by 36 NPIs, 300 clinicians

Practice addresses (Care Compare)

11915 Georgia Ave
Wheaton, MD 20902-2065
Phone (301) 942-4505

1805 Columbia Rd NW
Washington, DC 20009-2001
Phone (202) 797-4960

228 7TH St SE
Washington, DC 20003-4306
Phone (202) 698-0795

3064 Waldorf Market PL
Waldorf, MD 20603-4871
Phone (301) 932-5960

350 Fortune Ter
Suite D
Potomac, MD 20854-2910
Phone (443) 584-5323

6401 America Blvd
Hyattsville, MD 20782-2357
Phone (301) 276-8800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Urgent Care LLC CurrentSince Jul 2, 2023 Accepting new patients
Medstar Urgent Care LLC CurrentSince Jul 2, 2023 Accepting new patients

Locations

3007 Tilden St NW
Ste 5N
Washington, DC 20008

6317 York Rd
Baltimore, MD 21212
Phone (443) 777-6890

6401 America Blvd
Hyattsville, MD 20782
Phone (301) 209-5480

3064 Waldorf Market Pl
Waldorf, MD 20603
Phone (301) 932-5960

11915 Georgia Ave
Wheaton, MD 20902
Phone (301) 942-4505

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1665360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1154046449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6401 AMERICA BLVD",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207822357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 AMERICA BLVD",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207822357",
            "telephone_number": "855-910-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENO",
        "first_name": "HAWI",
        "middle_name": "ASSEFA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-10",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyattsville, MD

Sources for this page

Verify at the official NPI Registry.