Paulos Dereje Abebe, PA-C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0110010143 Issued in VA

Practice address

19415 Deerfield Ave Ste 301
Lansdowne, VA 20176-8472

Phone

(571) 367-0000

NPI assigned

Jul 1, 2024

Last updated

Jul 15, 2024By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: paulos.abebe.1@15876.direct.athenahealth.com

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.

• Nova Pulmonary Critical Care and Sleep Associates, LLC

  • Pulmonary Disease Physician
  • Dulles, VA
  • NPI 1932633682
  Medicare reassignment
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1750127684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44527 FIERY SKIPPER TER",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201472550",
            "telephone_number": "571-484-0328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19415 DEERFIELD AVE STE 301",
            "city": "LANSDOWNE",
            "state": "VA",
            "postal_code": "201768472",
            "telephone_number": "571-367-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABEBE",
        "first_name": "PAULOS",
        "middle_name": "DEREJE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0110010143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• A Wink and a Smile Denitst PLLC (a wink and a smile)
• Chandra Adhikari, APRN
• Adult and Geriatric Psychiatry
• Ashley Aguirre, RESIDENT
• Ali Al-Fakhri
• Allergy & Asthma Affiliates, Inc.

• Family Medicine Physician in Lansdowne, VA
• Providers in Lansdowne, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.