Makonnen K. Zelleke, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101232669 Issued in VA

Practice address

7740 Gunston PLZ
Lorton, VA 22079-1897

Phone

(703) 339-5858

Fax

(703) 339-5860

NPI assigned

Sep 29, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• DHHS PHS Naihs Crownpoint Hospital

  • General Acute Care Hospital
  • Crownpoint, NM
  • NPI 1114960093

  TX

  Medicare reassignment NPD
• Pueblo Pintado Clinic

  • Clinic/Center
  • Cuba, NM
  • NPI 1023051133
  NPD
• Thoreau Clinic

  • Clinic/Center
  • Thoreau, NM
  • NPI 1679516702
  NPD
• Hospital Physician Services, LLLP

  • General Acute Care Hospital
  • Westminster, MD
  • NPI 1457302713
  NPD (past)
• Howard University

  dba Faculty Practice Plan Howard University

  • Multi-Specialty Clinic/Center
  • Washington, DC
  • NPI 1033163597

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1700873429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7740 GUNSTON PLZ",
            "city": "LORTON",
            "state": "VA",
            "postal_code": "220791897",
            "telephone_number": "703-339-5858",
            "fax_number": "703-339-5860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7740 GUNSTON PLZ",
            "city": "LORTON",
            "state": "VA",
            "postal_code": "220791897",
            "telephone_number": "703-339-5858",
            "fax_number": "703-339-5860"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2199 Old Bridge Rd",
            "address_purpose": "LOCATION",
            "city": "Lake Ridge",
            "state": "VA",
            "postal_code": "221922911",
            "country_code": "US",
            "telephone_number": "703-357-9707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZELLEKE",
        "first_name": "MAKONNEN",
        "middle_name": "K.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "D0059191",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101232669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "VAExchange@patientfirstclinics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2199 Old Bridge Rd",
            "city": "Lake Ridge",
            "state": "VA",
            "country_code": "US",
            "postal_code": "221922911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Masey Wiedenmann, BEHAVIOR TECHNICIAN
• Williamsburg Square Family Practice,P.C.
• Melinda R Wowak, DPT
• Abhinav Yadav, DPT
• Liya Yosuf
• Irene Zen, PMHNP-BC, MSN, RN
• Zenhands Home Care LLC
• Zeponic Farms, Inc.
• Anh N Zirnstein, DDS
• Zowie LLC

• Pediatrics Physician in Lorton, VA
• Providers in Lorton, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.