Wondaye Tamene Deressa, NP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

R146322 Issued in MD

Practice address

8901 Rockville Pike
Bethesda, MD 20889-0001

Phone

(301) 400-1133

NPI assigned

Nov 30, 2009

Sex

Male

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

Nurse Practitioner

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

{
    "created_epoch": "1259539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1275861353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10040 FALL RAIN DR",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207235771",
            "telephone_number": "240-355-1325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 ROCKVILLE PIKE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890001",
            "telephone_number": "301-400-1133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Walter Reed Army Medical Ctr",
            "address_2": "6900 Georgia AVe, NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "203070001",
            "country_code": "US",
            "telephone_number": "202-782-3386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DERESSA",
        "first_name": "WONDAYE",
        "middle_name": "TAMENE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-30",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MD",
            "license": "R146322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paolo B Depetrillo, MD
• Thomas Michael Depietro, DO
• Evan Albert Ghin Chiang Der, MD, PHD
• Julie Derby, LCSW-C
• Joanne Derdak, CRNP
• Shreya Dushyant Desai, MD
• Lysette Deshields
• Naomi Elizabeth Deshore-Osborne, RN, CRNP
• Ronan Desmond, M.D.
• Christin B Destefano, M.D.

• Primary Care Nurse Practitioner in Bethesda, MD
• Providers in Bethesda, MD by specialty
• Primary Care Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; 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.