Individual provider Active NPI

Angesom Kibreab, MD

  • Internal Medicine Physician
  • Washington, DC
National Provider Identifier
1366601403
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD037438 Issued in DC
Practice address
2041 Georgia NW Ave
Washington, DC 20060-0001
Phone
(202) 865-3290
Fax
(202) 865-3833
NPI assigned
Jun 4, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2020

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 MD037438 DC Primary

Addresses

Primary practice location

2041 Georgia NW Ave
Washington, DC 20060-0001

Mailing address

2041 Georgia Ave NW Ste 6101
Washington, DC 20060-0001
Phone (202) 865-6679

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20121127000224 DC Practitioner - GastroenterologyPractitioner - Internal Medicine 4183875024 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Howard UniversityGroup PAC ID 0941109565, 182 clinicians

Practice addresses (Care Compare)

2041 Georgia NW Ave
Washington, DC 20060-0001
Phone (202) 865-6679

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy48
Upper gastrointestinal (GI) endoscopy for acid reflux31

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD037438DCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Howard University Internal Medicine CurrentSince Jan 1, 2014 Accepting new patients
Howard University CurrentSince Jan 26, 2020 Accepting new patients

Locations

2041 Georgia Ave NW
Washington, DC 20060
Phone (202) 865-3785

2041 Georgia Ave NW
#5000
Washington, DC 20060

2041 Georgia Ave NW
Ste 6101
Washington, DC 20060
Phone (202) 865-6679

2101 Medical Park Dr
Ste 305
Silver Spring, MD 20902
Phone (301) 754-0833

Interoperability endpoints

  • Direct secure messaging: angesomkibreab@hufp.allscriptsdirect.net

Organizations & group practices 2

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 1

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": "1212537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1366601403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2041 GEORGIA AVE NW STE 6101",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200600001",
            "telephone_number": "202-865-6679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 GEORGIA NW AVE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200600001",
            "telephone_number": "202-865-3290",
            "fax_number": "202-865-3833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIBREAB",
        "first_name": "ANGESOM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-04",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DC",
            "license": "MD037438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.