Marda Menbere Mengesha

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C0007480 Issued in MD

Practice address

345 Saint Paul St
Baltimore, MD 21202-2123

Phone

(410) 332-9000

NPI assigned

Feb 4, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Emergency Physicians SPPS

  • Emergency Medicine Physician
  • Baltimore, MD
  • NPI 1760885958
  Medicare reassignment
• Maryland Family Care, Inc.

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1598718256
  Medicare reassignment
• St. Paul Place Specialists, Inc.

  • Orthopaedic Foot and Ankle Surgery Physician
  • Baltimore, MD
  • NPI 1871549196
  Medicare reassignment
• St Paul Place Specialists Inc

  • Diagnostic Radiology Physician
  • Baltimore, MD
  • NPI 1497707681
  NPD
• St. Paul Place Specialists, Inc.

  • Gynecologic Oncology Physician
  • Baltimore, MD
  • NPI 1891741112
  NPD
• Vascular Specialty Services, LLC

  • Vascular Surgery Physician
  • Baltimore, MD
  • NPI 1003853706
  NPD (past)

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

{
    "created_epoch": "1549238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589846400000",
    "number": "1154886158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 WHITEHALL DR",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209042298",
            "telephone_number": "240-994-6040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 SAINT PAUL ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022123",
            "telephone_number": "410-332-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1720 Whitehall Dr",
            "address_purpose": "LOCATION",
            "city": "Silver Spring",
            "state": "MD",
            "postal_code": "209042298",
            "country_code": "US",
            "telephone_number": "240-994-6040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENGESHA",
        "first_name": "MARDA",
        "middle_name": "MENBERE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-04",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0007480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raelene Meneses, MS, CCC-SLP
• Matthew W. Menet, M.D.
• Carole Menetrez
• Steven Philip Menez, MD
• Lingguo Meng, PH.D.
• Firehiwot Abebe Mengistie, M.D
• Amanda Menke, LCSW-C
• Abigail Menken
• Menlo Pharmacy
• Menocal Medical Services PA

• Physician Assistant in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.