Individual provider Active NPI

Milen Mengistu, NP

  • Family Nurse Practitioner
  • Arlington, VA
National Provider Identifier
1568279636
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024190407 Issued in VA
Practice address
1201 S Hayes St
Arlington, VA 22202-2700
Phone
(703) 418-3790
NPI assigned
Dec 12, 2024
Last updated
Dec 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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 0024190407 VA Primary

Addresses

Primary practice location

1201 S Hayes St
Arlington, VA 22202-2700

Mailing address

6524 Delia Dr
Alexandria, VA 22310-2610
Phone (571) 435-0211

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250422001335 DC Practitioner - Nurse Practitioner 7416472592 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Marymount University, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

106 Irving St NW 4200
MMG at WHC
Washington, DC 20010-2979
Phone (202) 877-2200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024190407VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Apr 1, 2025 Accepting new patients
Medstar Medical Group II LLC CurrentSince Apr 1, 2025 Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

102 Irving St NW
Washington, DC 20010
Phone (202) 877-1587

106 Irving St NW
Ste 4200
Washington, DC 20010
Phone (202) 877-2200

106 Irving St NW
#3400N
Washington, DC 20010

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1733961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1568279636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6524 DELIA DR",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223102610",
            "telephone_number": "571-435-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S HAYES ST",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222022700",
            "telephone_number": "703-418-3790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENGISTU",
        "first_name": "MILEN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-12",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024190407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

Verify at the official NPI Registry.