Individual provider Active NPI

Tigist Woldegebrial Haileselassie, PA

  • Medical Physician Assistant
  • Laurel, MD
National Provider Identifier
1336681105
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
C0006033 Issued in MD
Practice address
3357B Corridor Marketplace
Laurel, MD 20724-2381
Phone
(301) 497-1820
NPI assigned
Nov 10, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X C0006033 MD Primary

Addresses

Primary practice location

3357B Corridor Marketplace
Laurel, MD 20724-2381

Mailing address

4903 Georgia Ave NW
Washington, DC 20011-4525
Phone (202) 723-0393

Other practice location 1

7225 Hanover Pkwy
A
Greenbelt, MD 20770-2024
Phone (301) 345-1400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MDExchange@patientfirst.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200302000075 DC Practitioner - Physician Assistant 4587091616 Reassigns benefits to 3 organizations
I20240304000371 MD Practitioner - Physician Assistant 4587091616 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
May accept Medicare assignment
Group practices
MNR Industries, LLCGroup PAC ID 7416908843, 142 clinicians
Patient First Maryland Medical Group PLLCGroup PAC ID 4385538735, shared by 26 NPIs, 258 clinicians

Practice addresses (Care Compare)

10416 Campus Way S
Expresscare of Largo
Largo, MD 20774-1390
Phone (301) 316-9620

107 Ridgely Ave
Suite 12
Annapolis, MD 21401-1417
Phone (410) 220-0720

1505 E Churchville Rd
Bel Air, MD 21014-4742

2401 E Belvedere Ave
Baltimore, MD 21215-5216

3357 Market PL
Laurel, MD 20724
Phone (301) 497-1820

40 S Dundalk Ave
Suite 400
Dundalk, MD 21222-4273
Phone (410) 220-0720

6000 Laurel Bowie Rd
Bowie, MD 20715-4000
Phone (301) 383-0330

8206 Georgia Ave
Silver Spring, MD 20910-4519
Phone (301) 960-4682

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MNR Industries, LLC CurrentSince Dec 1, 2024 Accepting new patients
MNR Industries, LLC CurrentSince Dec 1, 2024 Accepting new patients
Patient First Maryland Medical Group PLLC CurrentSince Nov 1, 2025 Accepting new patients
Patient First Maryland Medical Group PLLC CurrentSince Nov 1, 2025 Accepting new patients
MNR Industries LLC Current Accepting new patients
MNR Industries, LLC CurrentSince Dec 1, 2024 Accepting new patients
Patient First Maryland Medical Group, PLLC CurrentSince Nov 1, 2025 Accepting new patients
Matclinic Physicians Practice Group LLC CurrentSince Feb 20, 2024 Accepting new patients
Matclinic Physicians Practice Group LLC CurrentSince Feb 20, 2024 Accepting new patients

Locations

1505 E Churchville Rd
Bel Air, MD 21014
Phone (410) 420-6970

1505 E Churchville Rd
#A
Bel Air, MD 21014
Phone (410) 420-6970

6000 Laurel Bowie Rd
Bowie, MD 20715
Phone (301) 383-0330

40 S Dundalk Ave
Ste 400
Dundalk, MD 21222
Phone (410) 220-0270

1101 Opal Ct
Ste 301
Hagerstown, MD 21740
Phone (240) 329-9033

601 7th St
Ste 304
Laurel, MD 20707
Phone (410) 220-0280

3357B Corridor Marketplace
Laurel, MD 20724
Phone (301) 497-1820

3357 Corridor Marketplace
Laurel, MD 20724
Phone (301) 497-1820

504 E Ridgeville Blvd
#A
Mount Airy, MD 21771
Phone (301) 703-5452

10210 Reisterstown Rd
Owings Mills, MD 21117
Phone (410) 902-6776

726 Rockville Pike
Rockville, MD 20852
Phone (240) 238-0411

8206 Georgia Ave
Silver Spring, MD 20910
Phone (301) 960-4682

2855 Crain Hwy
Waldorf, MD 20601
Phone (240) 427-1926

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1478736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1336681105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4903 GEORGIA AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200114525",
            "telephone_number": "202-723-0393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3357B CORRIDOR MARKETPLACE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207242381",
            "telephone_number": "301-497-1820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7225 Hanover Pkwy",
            "address_2": "A",
            "address_purpose": "LOCATION",
            "city": "Greenbelt",
            "state": "MD",
            "postal_code": "207702024",
            "country_code": "US",
            "telephone_number": "301-345-1400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAILESELASSIE",
        "first_name": "TIGIST",
        "middle_name": "WOLDEGEBRIAL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-10",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0006033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MDExchange@patientfirst.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3357B Corridor Marketplace",
            "city": "Laurel",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207242381",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

Verify at the official NPI Registry.