Individual provider Active NPI

Ejegayehu Terefe-Gifawossen, MD

  • Internal Medicine Physician
  • Kokomo, IN
National Provider Identifier
1750563623
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0077157 Issued in MD
Practice address
3500 S Lafountain St
Kokomo, IN 46902-3803
Phone
(765) 865-8630
Fax
(765) 864-5901
NPI assigned
Dec 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0077157 MD Primary
Internal Medicine Physician 207R00000X 01068519 IN
Hospitalist Physician 208M00000X 01068519 IN

Addresses

Primary practice location

3500 S Lafountain St
Kokomo, IN 46902-3803

Mailing address

6626 E 75TH St
Suite 500
Indianapolis, IN 46250-2890

Other identifiers 3

IdentifierTypeStateIssuer
200996560MedicaidIN
P01270943OtherINRR MEDICARE
P00905153OtherINRAILROAD MEDICARE PTAN

Other names 1

  • Ejegayehu Gifawossen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140620000256 DC Practitioner - Internal MedicinePractitioner - Hospitalist 3678606118 Reassigns benefits to 5 organizations
I20170309000956 MD Practitioner - HospitalistPractitioner - Internal Medicine 3678606118 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Synergy Medical Group LLCGroup PAC ID 0749644177, 102 clinicians
Galen Inpatient Physicians PCGroup PAC ID 3678464633, 1,045 clinicians

Practice addresses (Care Compare)

1205 York Rd
Suite 11
Timonium, MD 21093-6211
Phone (443) 325-0031

19801 Observation Dr
Germantown, MD 20876-4070
Phone (301) 557-5928

2729 King St
Alexandria, VA 22302-4008
Phone 70383688384008

299 Hurley Ave
Rockville, MD 20850-3118
Phone (301) 279-9000

3210 Powder Mill Rd
Hyattsville, MD 20783-1029
Phone (301) 937-3939

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0077157MDMDInternal Medicine Physician
01068519INMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Medical Group LLC Internal Medicine Current Accepting new patients
Galen Inpatient Physicians PC Hospitalist CurrentSince Sep 14, 2025 Accepting new patients
Synergy Medical Group LLC Internal Medicine CurrentSince Feb 20, 2024 Accepting new patients
Synergy Medical Group LLC Internal Medicine CurrentSince Feb 20, 2024 Accepting new patients
Hospitalist Medicine Physicians of Maryland PC Internal Medicine CurrentSince Jan 1, 2014 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Jun 30, 2019 Accepting new patients
Galen Inpatient Physicians PC Hospitalist CurrentSince Sep 14, 2025 Accepting new patients
Emergency Medicine Associates P.a., P.C. Internal Medicine CurrentSince Jun 30, 2019 Accepting new patients
Galen Inpatient Physicians PC Hospitalist Current Accepting new patients
Usacs Integrated Acute Care Services of Maryland, LLC Internal Medicine CurrentSince Jul 1, 2019 Accepting new patients
Hospitalist Medicine Physicians of Maryland PC Internal Medicine CurrentSince Jan 1, 2014 Accepting new patients
Synergy Medical Group LLC Internal Medicine CurrentSince Feb 20, 2024 Accepting new patients
Holy Cross Health, Inc Past Accepting new patients
Hillhaven SNF Operator LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Indiana Clinic Critical Care LLC Internal Medicine Past Accepting new patients

Locations

5255 Loughboro Rd NW
Washington, DC 20016
Phone (202) 243-2280

400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300

19801 Observation Dr
Germantown, MD 20876
Phone (301) 557-5928

3001 Hospital Dr
Hyattsville, MD 20785
Phone (301) 618-2000

3210 Powder Mill Rd
Hyattsville, MD 20783
Phone (301) 937-3939

299 Hurley Ave
Rockville, MD 20850
Phone (301) 762-8900

9901 Medical Center Dr
Rockville, MD 20850
Phone (301) 279-6000

1500 Forest Glen Rd
Silver Spring, MD 20910
Phone (301) 754-7230

7600 Carroll Ave
Takoma Park, MD 20912
Phone (301) 791-7600

1205 York Rd
Ste 11
Timonium, MD 21093
Phone (443) 325-0031

200 Memorial Ave
Westminster, MD 21157
Phone (410) 848-3000

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1750563623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "SUITE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 S LAFOUNTAIN ST",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023803",
            "telephone_number": "765-865-8630",
            "fax_number": "765-864-5901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEREFE-GIFAWOSSEN",
        "first_name": "EJEGAYEHU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-03",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0077157",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01068519",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01068519",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200996560",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01270943",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "P00905153",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EJEGAYEHU",
            "last_name": "GIFAWOSSEN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kokomo, IN

Sources for this page

Verify at the official NPI Registry.