Individual provider Active NPI

Kelemework Kentiba Wodiye, MD

  • Internal Medicine Physician
  • Reston, VA
National Provider Identifier
1518102433
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101247574 Issued in VA
Practice address
1800 Town Center Dr
Reston Hospital
Reston, VA 20190-3215
Phone
(510) 734-9037
NPI assigned
Dec 5, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 0101247574 VA
Internal Medicine Physician 207R00000X 0101247574 VA Primary

Addresses

Primary practice location

1800 Town Center Dr
Reston Hospital
Reston, VA 20190-3215

Mailing address

1800 Town Center
Reston, VA 20190
Phone (510) 734-9037

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110411000647 DC Practitioner - Internal Medicine 1254515521 Reassigns benefits to 1 organization
I20110627000185 VA Practitioner - Internal Medicine 1254515521 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

15225 Heathcote Blvd
Haymarket, VA 20169-6264
Phone (240) 686-2300

1701 N George Mason Dr
Arlington, VA 22205-3610
Phone (703) 558-5000

1850 Town Ctr Pkwy
Reston, VA 20190-3204
Phone (240) 686-2300

24440 Stone Springs Blvd
Dulles, VA 20166-2247
Phone (240) 686-2300

24570 Stone Springs Blvd
Dulles, VA 20166-2247
Phone (240) 686-2300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.6 of 100Reported as group
Quality
76.36
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Medicine Services of VA, LLC Hospitalist CurrentSince Apr 1, 2023 Accepting new patients
Emergency Medicine Associates, P.a.,P.C. Internal Medicine CurrentSince Oct 1, 2020 Accepting new patients
Virginia Hospitalists Inc Internal Medicine Past Accepting new patients
Reston Hospitalists, LLC Internal Medicine Past Accepting new patients

Locations

20010 Century Blvd
Ste 200
Germantown, MD 20874

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

100 Fairview Dr
Franklin, VA 23851
Phone (757) 516-1153

4600 Spotsylvania Pkwy
Fredericksburg, VA 22408
Phone (540) 498-4000

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

1850 Town Center Pkwy
Reston, VA 20190
Phone (703) 478-0922

7101 Jahnke Rd
#611
Richmond, VA 23225
Phone (540) 498-4000

Organizations & group practices 5

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 2

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": "1228435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1518102433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 TOWN CENTER",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "20190",
            "telephone_number": "510-734-9037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 TOWN CENTER DR",
            "address_2": "RESTON HOSPITAL",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903215",
            "telephone_number": "510-734-9037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WODIYE",
        "first_name": "KELEMEWORK",
        "middle_name": "KENTIBA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-05",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0101247574",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101247574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

Verify at the official NPI Registry.