Individual provider Active NPI

Ivara Alistair Esege, M.B.B.S.

  • Specialist
  • Baltimore, MD
National Provider Identifier
1306885280
Registry record updated Jun 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
D46071 Issued in MD
Practice address
4538 Edmondson Ave
Baltimore, MD 21229-1506
Phone
(410) 328-2273
Fax
(410) 328-1748
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X D46071 MD Primary

Addresses

Primary practice location

4538 Edmondson Ave
Baltimore, MD 21229-1506

Mailing address

4538 Edmondson Ave
Baltimore, MD 21229-1506
Phone (410) 328-2273

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090518000280 MD Practitioner - Family PracticePractitioner - Emergency Medicine 2163571324 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Family Medicine Associates, P.a. Specialist CurrentSince Oct 6, 1996 Accepting new patients
University of Maryland Faculty Physicians Immediate Care, LLC CurrentSince May 1, 2016 Accepting new patients
University of Maryland Family Medicine Associates, P.a. Specialist Current Accepting new patients
University Care Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

4538 Edmondson Ave
Baltimore, MD 21229
Phone (410) 328-2273

419 W Redwood St
Ste 220
Baltimore, MD 21201
Phone (410) 328-3306

5890 Waterloo Rd
Columbia, MD 21045
Phone (410) 328-2603

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243900800000",
    "number": "1306885280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4538 EDMONDSON AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212291506",
            "telephone_number": "410-328-2273",
            "fax_number": "410-328-1748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4538 EDMONDSON AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212291506",
            "telephone_number": "410-328-2273",
            "fax_number": "410-328-1748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESEGE",
        "first_name": "IVARA",
        "middle_name": "ALISTAIR",
        "name_prefix": "Dr.",
        "credential": "M.B.B.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2009-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "D46071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.