Individual provider Active NPI

Getachew Tefferra, M.D

  • Internal Medicine Physician
  • Upper Marlboro, MD
National Provider Identifier
1770625907
Registry record updated Dec 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0057218 Issued in MD
Practice address
1221 Mercantile LN
Upper Marlboro, MD 20774-5374
Phone
(301) 618-5500
NPI assigned
Feb 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0057218 MD Primary

Addresses

Primary practice location

1221 Mercantile LN
Upper Marlboro, MD 20774-5374

Mailing address

PO Box 64442
Baltimore, MD 21264-4442
Phone (410) 547-8500

Other identifiers 2

IdentifierTypeStateIssuer
S062-0499OtherMDCAREFIRST
413372200MedicaidMD

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC, VA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20070913000413 MD Practitioner - Internal Medicine 6507950136 Reassigns benefits to 1 organization
I20101213000632 DC Practitioner - Internal Medicine 6507950136 Reassigns benefits to 2 organizations
I20210622000934 VA Practitioner - Internal Medicine 6507950136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, 1,921 clinicians

Practice addresses (Care Compare)

1221 Mercantile LN
Largo, MD 20774-5374
Phone (301) 618-5700

14139 Potomac Mills Rd
Woodbridge, VA 22192-4644
Phone (703) 257-3000

Hospital & facility affiliations

  • Americare in Home Nursing Home health agency, Fort Washington, MD, CCN 217152

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0057218MDMDInternal Medicine Physician
D57218MDMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Oct 3, 2016 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Internal Medicine Current Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Mar 17, 2021 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Internal Medicine Current Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Oct 3, 2016 Accepting new patients
Alexandria Hospitalists, LLC Past Accepting new patients

Locations

2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853

2101 E Jefferson St
Ste 6
Rockville, MD 20852

2101 E Jefferson St
Ste 4EAST
Rockville, MD 20852

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

14139 Potomac Mills Rd
Woodbridge, VA 22192
Phone (703) 257-3000

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1770625907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64442",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644442",
            "telephone_number": "410-547-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 MERCANTILE LN",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207745374",
            "telephone_number": "301-618-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEFFERRA",
        "first_name": "GETACHEW",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0057218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "S062-0499",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "413372200",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "c-cda",
            "address_1": "1221 Mercantile Ln",
            "city": "Upper Marlboro",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207745374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Upper Marlboro, MD

Sources for this page

Verify at the official NPI Registry.