Misgana Mesfin Belege, PA-C
Individual provider Active NPI Surgical Physician Assistant · Randallstown, MD
NPI 1487813465 · NPPES record last updated Nov 5, 2019
Key facts
- NPI
- 1487813465
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Physician Assistant 363AS0400X
- License
- PA030536 (MD)
- Practice address
- 5401 Old Court Rd
Randallstown, MD 21133-5103 - Phone
- (410) 521-2200
- NPI assigned
- Jun 5, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Northwest Hospital Center Inc
Practice addresses (Care Compare)
5401 Old Court Rd
Randallstown, MD 21133-5103
Phone (410) 701-4434
Hospital & facility affiliations
- Northwest Hospital Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in DC, NC, MD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080918000708 | DC | Practitioner - Physician Assistant | 3375610223 | Reassigns benefits to 1 organization |
| I20151118001960 | NC | Practitioner - Physician Assistant | 3375610223 | Reassigns benefits to 1 organization |
| I20190808003975 | MD | Practitioner - Physician Assistant | 3375610223 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA030536 | MD | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Novant Health Medical Group, LLC | Current |
Accepting new patients | |
| Northwest Hospital Center, Inc | Physician Assistant | Current |
Accepting new patients |
| Novant Health Medical Group, LLC | Current |
Accepting new patients |
Locations
5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727
5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441
6 Doctors Cir
Ste 5
Supply, NC 28462
Phone (910) 721-4370
2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 001005631 | NC | |
| Surgical Physician Assistant | 363AS0400X | |||
| Surgical Physician Assistant | 363AS0400X | PA030536 | MD | Yes |
Addresses
Primary practice location
5401 Old Court Rd
Randallstown, MD 21133-5103
Mailing address
5401 Old Court Rd
Randallstown, MD 21133-5103
Phone (410) 521-2200
Other practice location 1
6 Doctors Cir Ste 5
Supply, NC 28462-6358
Phone (910) 754-5988
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487813465 | Other | 1487813465 | |
| 1487813465 | Other | NPI |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mgebeyehu@lifebridgehealth.org | ||
| Direct Messaging Address | mgebeyehu@lifebridgehealth.org |
Other providers in Randallstown, MD
- BB-Penda
- Be More Inc.
- John Bednar
- Eric Gerard Beglan
- Woinshet Bekele-Jembere
- Believing N Daily Journeys LLC
- Amanda Christine Bell
- Bella Home Care LLC
- Kafayat Olabisi Bello-Ogundipe
- Mandi G Berman
All providers in Randallstown, MD · Surgical Physician Assistant in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 5, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.