Individual provider Active NPI

Bernadine Ihediohanma

  • Family Nurse Practitioner
  • Washington, DC
National Provider Identifier
1457942575
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R172509 Issued in MD
Practice address
39 V St NE
Washington, DC 20002-1329
Phone
(551) 295-8223
NPI assigned
Feb 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R172509 MD Primary

Addresses

Primary practice location

39 V St NE
Washington, DC 20002-1329

Mailing address

2 University PLZ Ste 204
Hackensack, NJ 07601-6211
Phone (551) 295-8223

Other practice location 1

9607 Justin Ln
Laurel, MD 20723-1801
Phone (301) 922-1388

Other practice location 2

962 Wayne Ave Ste 250
Silver Spring, MD 20910-4433
Phone (551) 295-8223

Other names 1

  • Bernadine Ihediohanma Professional name

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
I20210526000519 DC Practitioner - Nurse Practitioner 9739588625 Reassigns benefits to 4 organizations
I20250319002407 MD Practitioner - Nurse Practitioner 9739588625 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ennoble HC DMV LLCGroup PAC ID 9032517925, 112 clinicians

Practice addresses (Care Compare)

8115 Maple Lawn Blvd
Suite 350
Fulton, MD 20759-2683
Phone (973) 435-9463

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R172509MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ennoble HC DMV II LLC CurrentSince Oct 16, 2025 Accepting new patients
Ennoble HC DMV LLC CurrentSince Sep 1, 2024 Accepting new patients
Rahel G. Yirga MD PC CurrentSince Apr 21, 2021 Accepting new patients
Ennoble HC DMV III LLC CurrentSince Oct 16, 2025 Accepting new patients

Locations

1500 K St NW
Fl 2
Washington, DC 20005
Phone (212) 287-4257

1500 K St NW
Ofc 226A
Washington, DC 20005
Phone (862) 812-9010

8115 Maple Lawn Blvd
Ste 350
Fulton, MD 20759
Phone (240) 744-0001

962 Wayne Ave
Ste 250
Silver Spring, MD 20910
Phone (240) 744-0001

2 University Plz
Ste 204
Hackensack, NJ 07601
Phone (201) 564-0142

6035 Burke Centre Pkwy
Ste 390
Burke, VA 22015
Phone (703) 978-0756

Interoperability endpoints

  • Direct secure messaging: bernadine.ihediohanma.1@28492.direct.athenahealth.com

Organizations & group practices 4

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": "1612137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1457942575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 UNIVERSITY PLZ STE 204",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076016211",
            "telephone_number": "551-295-8223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 V ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200021329",
            "telephone_number": "551-295-8223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9607 Justin Ln",
            "address_purpose": "LOCATION",
            "city": "Laurel",
            "state": "MD",
            "postal_code": "207231801",
            "country_code": "US",
            "telephone_number": "301-922-1388",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "962 Wayne Ave Ste 250",
            "address_purpose": "LOCATION",
            "city": "Silver Spring",
            "state": "MD",
            "postal_code": "209104433",
            "country_code": "US",
            "telephone_number": "551-295-8223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IHEDIOHANMA",
        "first_name": "BERNADINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-01",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R172509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BERNADINE",
            "last_name": "IHEDIOHANMA",
            "credential": "DNP, NP-C, CRNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.