Individual provider Active NPI

Mariamawit Kebede Tilahun

  • Physician Assistant
  • Alexandria, VA
National Provider Identifier
1639024227
Registry record updated Feb 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3610 King St Ste D
Alexandria, VA 22302-1908
Phone
(855) 910-3278
NPI assigned
Feb 28, 2026
Last updated
Feb 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

3610 King St Ste D
Alexandria, VA 22302-1908

Mailing address

10980 Grantchester Way
Columbia, MD 21044-6097
Phone (410) 772-6500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 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
I20260421000771 MD Practitioner - Physician Assistant 4183190754 Reassigns benefits to 1 organization
I20260421001083 DC Practitioner - Physician Assistant 4183190754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Howard University College of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Urgent Care LLCGroup PAC ID 9335303155, 300 clinicians

Practice addresses (Care Compare)

11915 Georgia Ave
Wheaton, MD 20902-2065
Phone (301) 942-4505

12111 Darnestown Rd
Gaithersburg, MD 20878-3211
Phone (301) 926-3095

20 University Blvd E
Silver Spring, MD 20901-2436
Phone (240) 863-2720

2114 Generals Hwy
Annapolis, MD 21401-7488
Phone (410) 224-6905

3064 Waldorf Market PL
Waldorf, MD 20603-4871
Phone (301) 932-5960

4507 Stanford St
Bethesda, MD 20815-5205
Phone (443) 302-9258

500 Charles St
La Plata, MD 20646-5931
Phone (410) 451-1800

6317 York Rd
Baltimore, MD 21212-2310
Phone (443) 777-6890

6401 America Blvd
Hyattsville, MD 20782-2357
Phone (301) 276-8800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1772236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772236800000",
    "number": "1639024227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10980 GRANTCHESTER WAY",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210446097",
            "telephone_number": "410-772-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 KING ST STE D",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223021908",
            "telephone_number": "855-910-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILAHUN",
        "first_name": "MARIAMAWIT",
        "middle_name": "KEBEDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-28",
        "last_updated": "2026-02-28",
        "certification_date": "2026-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.