NPIMap

Individual provider Active NPI

Benorayehush Weldetsadik, M.D.

  • Internal Medicine Physician
  • Columbia, MD
National Provider Identifier
1255579744
Registry record updated Mar 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0071233 Issued in MD
Practice address
10710 Charter Dr
Suite 310
Columbia, MD 21044-3128
Phone
(410) 997-5944
Fax
(410) 997-1720
NPI assigned
Jan 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2012

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 D0071233 MD Primary

Addresses

Primary practice location

10710 Charter Dr
Suite 310
Columbia, MD 21044-3128

Mailing address

10710 Charter Dr
Suite 310
Columbia, MD 21044-3128
Phone (410) 997-5944

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110324000256 DC Practitioner - Internal Medicine 6507049814 Reassigns benefits to 3 organizations
I20120110000377 MD Practitioner - Internal Medicine 6507049814 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Graceway Health Care LLCGroup PAC ID 9537544648, 15 clinicians

Practice addresses (Care Compare)

111 W Rd
Towson, MD 21204-2315
Phone (667) 300-8222

9106 Pine View LN
Clinton, MD 20735-3229
Phone (301) 856-2930

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0071233MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Graceway Health Care LLC Internal Medicine CurrentSince Nov 22, 2021 Accepting new patients
Graceway Health Care LLC Internal Medicine Current Accepting new patients
Hospitalist Medicine Physicians of Maryland PC Internal Medicine CurrentSince Feb 1, 2011 Accepting new patients
Graceway Health Care LLC Internal Medicine Current Accepting new patients
Graceway Health Care LLC Internal Medicine CurrentSince Jun 1, 2022 Accepting new patients
Hospitalist Medicine Physicians of Maryland PC Internal Medicine CurrentSince Feb 1, 2011 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
115 East Melrose Opco LLC Past Accepting new patients
8720 Emge Opco LLC Past Accepting new patients

Locations

9106 Pine View Ln
Clinton, MD 20735
Phone (301) 856-2930

7520 Surratts Rd
Clinton, MD 20735
Phone (301) 856-1600

9211 Stuart Ln
Clinton, MD 20735
Phone (301) 868-3600

347 Ballenger Center Dr
Frederick, MD 21703
Phone (301) 633-5181

3001 Hospital Dr
Hyattsville, MD 20785
Phone (301) 618-2000

111 West Rd
Towson, MD 21204
Phone (410) 828-6500

Organizations & group practices 10

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 4

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": "1232582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332115200000",
    "number": "1255579744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10710 CHARTER DR",
            "address_2": "SUITE 310",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443128",
            "telephone_number": "410-997-5944",
            "fax_number": "410-997-1720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10710 CHARTER DR",
            "address_2": "SUITE 310",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443128",
            "telephone_number": "410-997-5944",
            "fax_number": "410-997-1720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELDETSADIK",
        "first_name": "BENORAYEHUSH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-22",
        "last_updated": "2012-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0071233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.