Selamawit Belay Abegaz
Individual provider Active NPI Obstetrics & Gynecology Nurse Practitioner · Frederick, MD
NPI 1619794047 · NPPES record last updated Sep 25, 2024
Key facts
- NPI
- 1619794047
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Nurse Practitioner 363LX0001X
- License
- R228940 (MD)
- Practice address
- 61 Thomas Johnson Dr
Frederick, MD 21702-4301 - Phone
- (301) 663-6171
- NPI assigned
- Sep 25, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Capital Womens Care LLC
Practice addresses (Care Compare)
3430 Worthington Blvd
Suite 202
Urbana, MD 21704-7019
Phone (240) 699-0003
504 E Ridgeville Blvd
Mount Airy, MD 21771-5942
61 Thomas Johnson Dr
Frederick, MD 21702-4301
Phone (301) 663-6171
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in 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 |
|---|---|---|---|---|
| I20241230000236 | MD | Practitioner - Nurse Practitioner | 5395272520 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R228940 | MD | MD | Obstetrics & Gynecology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Capital Women'S Care, L.L.C. | Current |
Accepting new patients | |
| Capital Women'S Care, L.L.C. | Current | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Locations
61 Thomas Johnson Dr
Frederick, MD 21702
Phone (301) 663-6171
504 E Ridgeville Blvd
Ste 108
Mount Airy, MD 21771
Phone (301) 663-6171
3430 Worthington Blvd
Ste 202
Urbana, MD 21704
Phone (240) 699-0003
5801 Postal Rd
Unit 81310
Cleveland, OH 44181
Interoperability endpoints
- selamawit.abegaz.p1@direct.cwcare.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Nurse Practitioner | 363LX0001X | R228940 | MD | Yes |
Addresses
Primary practice location
61 Thomas Johnson Dr
Frederick, MD 21702-4301
Mailing address
10741 Venetia Mill Cir
Silver Spring, MD 20901-1584
Phone (301) 213-4470
Other providers in Frederick, MD
- Ghulam Abbas
- Sarah E Abbott
- Elias Kamal Abdi
- Aisha Abdul-Samad
- Sunia Abdula-Lessing
- Rommie Navylia Abele
- Abiding Tide Therapy and Wellness LLC
- Ability Prosthetics & Orthotics, LLC
- Above All Physical Therapy LLC
- Reeba Anna Abraham
All providers in Frederick, MD · Obstetrics & Gynecology Nurse Practitioner in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 25, 2024. 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.