Eugide Kasongo Othepa, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

D0102990 Issued in MD

Practice address

10614 Racetrack Rd Unit 5
Berlin, MD 21811-3383

Phone

(410) 208-9761

NPI assigned

Mar 31, 2022

Last updated

Jul 9, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Eugide Kasongo-Othepa Former name

Medicare fee-for-service enrollment

Enrolled in MD

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 1

Specialty

Family Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tidalhealth Atlantic IncGroup PAC ID 2365437837, 95 clinicians

Tidalhealth Primary Care LLCGroup PAC ID 7911320635, 63 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Atlantic General Hospital Hospital, Berlin, MD, CCN 210061
• Tidalhealth Peninsula Regional, Inc Hospital, Salisbury, MD, CCN 210019

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Atlantic General Hospital Corporation

  dba Atlantic General Health System

  • Family Medicine Physician
  • Berlin, MD
  • NPI 1871582171
  Medicare reassignment Care Compare group NPD
• Tidalhealth Primary Care, LLC

  • Family Medicine Physician
  • Salisbury, MD
  • NPI 1104453208
  Medicare reassignment Care Compare group NPD
• Atlantic General Hospital Corp

  dba Atlantic General Health Systems WOC Imaging Center

  • Radiology Clinic/Center
  • Ocean City, MD
  • NPI 1043756232
  NPD
• Tidalhealth Atlantic, Inc.

  dba AGHRx RediScripts Ocean Pines

  • Community/Retail Pharmacy
  • Berlin, MD
  • NPI 1740963859
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Tidalhealth Atlantic, Inc

  dba Atlantic General Hospital Corp

  • General Acute Care Hospital
  • Berlin, MD
  • NPI 1053309120
  Care Compare affiliation
• Tidalhealth Peninsula Regional, Inc.

  • General Acute Care Hospital
  • Salisbury, MD
  • NPI 1780689463
  Care Compare affiliation

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

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1639819212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7045 ANTEBELLUM WAY",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217037479",
            "telephone_number": "571-458-9569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10614 RACETRACK RD UNIT 5",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218113383",
            "telephone_number": "410-208-9761"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7045 Antebellum Way",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217037479",
            "country_code": "US",
            "telephone_number": "571-458-9569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTHEPA",
        "first_name": "EUGIDE",
        "middle_name": "KASONGO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-31",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0102990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EUGIDE",
            "last_name": "KASONGO-OTHEPA",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Samantha Amanda Opher
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• Danielle J Orr, MD
• Adaeze Oruruo
• Kaitlyn Jones Osowiecki, LCSW-C
• Gerard Frederick Ott, D.M.D.
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• Georgette Paegar
• Mercy Esther Paegar, CNA, CMT
• La-Toya Sharnett Palmer-Hunter

• Family Medicine Physician in Berlin, MD
• Providers in Berlin, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.