NPIMap

Individual provider Active NPI

Atitegeb Tibebu, MD

  • Internal Medicine Physician
  • MC Lean, VA
National Provider Identifier
1225190168
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101840610 Issued in VA
Practice address
6845 Elm St Ste 710
MC Lean, VA 22101-3851
Phone
(703) 205-2626
Fax
(703) 205-7323
NPI assigned
Dec 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0053643 MD
Internal Medicine Physician 207R00000X 0101840610 VA Primary

Addresses

Primary practice location

6845 Elm St Ste 710
MC Lean, VA 22101-3851

Mailing address

PO Box 37174
Baltimore, MD 21297-3174
Phone (571) 423-5741

Other practice location 1

6409 S. Crain Highway
Route 301
Upper Marlboro, MD 20772-4139
Phone (301) 952-8614

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address atibebu665035@soc.inova.org Health Information Exchange (HIE) Inova Physician Partners, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20070130000626 DC Practitioner - Internal Medicine 7719988948 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Inova Physician Partners LLCGroup PAC ID 2466581772, 258 clinicians

Practice addresses (Care Compare)

6845 Elm St
Suite 710
MC Lean, VA 22101-3851
Phone (703) 848-8500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.98 of 100Reported as apm
Quality
87.97
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101840610VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Physician Partners, LLC CurrentSince Oct 21, 2019 Accepting new patients
Cignet Health Uplift Medical Past Accepting new patients
Inova Health Care Services Internal Medicine Past Accepting new patients
Hospital Physician Services, LLLP Internal Medicine Past Accepting new patients
Hospitalist Medicine Physicians of Maryland PC Internal Medicine Past Accepting new patients
Medical & Surgical Clinics of Southern Maryland Inc Internal Medicine Past Accepting new patients
Inova Physician Partners, Inc. - Specialists Past Accepting new patients
Metropolitan Medical Specialists LLC Internal Medicine Past Accepting new patients
Inpatient Specialists PA Internal Medicine Past Accepting new patients
Matrix House Physicians PA Internal Medicine Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

3914 Centreville Rd
Ste 250
Chantilly, VA 20151
Phone (703) 435-1223

6845 Elm St
Ste 710
McLean, VA 22101
Phone (703) 848-8500

Organizations & group practices 11

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 6

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": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1225190168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37174",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973174",
            "telephone_number": "571-423-5741",
            "fax_number": "301-627-1603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6845 ELM ST STE 710",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221013851",
            "telephone_number": "703-205-2626",
            "fax_number": "703-205-7323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6409 S. Crain Highway",
            "address_2": "Route 301",
            "address_purpose": "LOCATION",
            "city": "Upper Marlboro",
            "state": "MD",
            "postal_code": "207724139",
            "country_code": "US",
            "telephone_number": "301-952-8614",
            "fax_number": "301-627-1603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIBEBU",
        "first_name": "ATITEGEB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0053643",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101840610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "atibebu665035@soc.inova.org",
            "affiliation": "Y",
            "endpointDescription": "Health Information Exchange",
            "affiliationName": "Inova Physician Partners, LLC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "6845 Elm St Ste 710",
            "city": "Mc Lean",
            "state": "VA",
            "country_code": "US",
            "postal_code": "221013851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in MC Lean, VA

Sources for this page

Verify at the official NPI Registry.