NPIMap

Individual provider Active NPI

Yared Alemayehu Ayichew, MD

  • Internal Medicine Physician
  • Silver Spring, MD
National Provider Identifier
1184745184
Registry record updated May 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101241403 Issued in VA
Practice address
8060 13TH St
Apt. #803
Silver Spring, MD 20910-4801
Phone
(301) 588-1506
NPI assigned
Apr 3, 2007
Last updated
May 20, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101241403 VA Primary

Addresses

Primary practice location

8060 13TH St
Apt. #803
Silver Spring, MD 20910-4801

Mailing address

3833 Cullingworth Rd
Burtonsville, MD 20866-3115
Phone (202) 550-2392

Other identifiers 1

IdentifierTypeStateIssuer
1184745184MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080708000566 VA Practitioner - Internal Medicine 7810069895 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Spring Physician Services, LLCGroup PAC ID 1254689482, 89 clinicians

Practice addresses (Care Compare)

1900 Electric Rd
Salem, VA 24153-7474
Phone (540) 776-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101241403VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Spring Physician Services, LLC CurrentSince Jul 3, 2018 Accepting new patients
Kingsford Physician Services, LLC CurrentSince Sep 28, 2020 Accepting new patients
Ingleside Physician Services, LLC CurrentSince Sep 27, 2020 Accepting new patients

Locations

1 Arh Ln
Low Moor, VA 24457
Phone (540) 345-2593

2400 Lee Hwy N
Pulaski, VA 24301
Phone (540) 994-8100

1900 Electric Rd
Salem, VA 24153
Phone (540) 772-3400

Organizations & group practices 3

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

Hospital & facility affiliations 7

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": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369008000000",
    "number": "1184745184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3833 CULLINGWORTH RD",
            "city": "BURTONSVILLE",
            "state": "MD",
            "postal_code": "208663115",
            "telephone_number": "202-550-2392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8060 13TH ST",
            "address_2": "APT. #803",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209104801",
            "telephone_number": "301-588-1506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYICHEW",
        "first_name": "YARED",
        "middle_name": "ALEMAYEHU",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2013-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101241403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184745184",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

Verify at the official NPI Registry.