Active NPI
Asresahgn M Getachew, M.D.
- Clinic/Center
- Largo, MD
National Provider Identifier
1396808705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- License
- D0042804
- Practice address
- 1400 Mercantile LN
Suite 180
Largo, MD 20774-5341 - Phone
- (301) 925-7022
- Fax
- (301) 925-4463
- NPI assigned
- Dec 18, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | D0042804 | MD | Primary |
Addresses
Primary practice location
1400 Mercantile LN
Suite 180
Largo, MD 20774-5341
Mailing address
1400 Mercantile LN
Suite 180
Largo, MD 20774-5341
Phone (301) 925-7022
Other practice location 1
8492 Baltimore National Pike Ste 205
Ellicott City, MD 21043-3378
Phone (443) 671-1414
Other practice location 2
11 E Mount Royal Ave # Ll
Baltimore, MD 21202-2714
Phone (443) 671-1414
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 651191100 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1396808705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 MERCANTILE LN",
"address_2": "SUITE 180",
"city": "LARGO",
"state": "MD",
"postal_code": "207745341",
"telephone_number": "301-925-7022",
"fax_number": "301-925-4463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 MERCANTILE LN",
"address_2": "SUITE 180",
"city": "LARGO",
"state": "MD",
"postal_code": "207745341",
"telephone_number": "301-925-7022",
"fax_number": "301-925-4463"
}
],
"practiceLocations": [
{
"address_1": "8492 Baltimore National Pike Ste 205",
"address_purpose": "LOCATION",
"city": "Ellicott City",
"state": "MD",
"postal_code": "210433378",
"country_code": "US",
"telephone_number": "443-671-1414",
"fax_number": "443-671-1420",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "11 E Mount Royal Ave # Ll",
"address_purpose": "LOCATION",
"city": "Baltimore",
"state": "MD",
"postal_code": "212022714",
"country_code": "US",
"telephone_number": "443-671-1414",
"fax_number": "443-671-1420",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GETACHEW",
"first_name": "ASRESAHGN",
"middle_name": "M",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-18",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": "MD",
"license": "D0042804",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "651191100",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Largo, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.