Individual provider Active NPI

Esayas Tekle, PA-C

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1770875122
Registry record updated May 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0004355 Issued in MD
Practice address
827 Linden Ave
Baltimore, MD 21201-4606
Phone
(410) 225-8000
NPI assigned
May 4, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0004355 MD Primary

Addresses

Primary practice location

827 Linden Ave
Baltimore, MD 21201-4606

Mailing address

PO Box 64522
Baltimore, MD 21264-4522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110712000073 MD Practitioner - Physician Assistant 8628246915 Reassigns benefits to 2 organizations
I20121017000626 DC Practitioner - Physician Assistant 8628246915 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2540 Centreville Rd
Centreville, MD 21617-2681
Phone (410) 822-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Hospital Center Corp CurrentSince Sep 2, 2012 Accepting new patients
University of Maryland Community Medical Group, Inc. CurrentSince Aug 4, 2019 Accepting new patients
Johns Hopkins University CurrentSince Aug 1, 2021 Accepting new patients
Johns Hopkins University CurrentSince Aug 1, 2021 Accepting new patients
Dimensions Health Associates Dba University of Maryland Capital Region CurrentSince Mar 1, 2025 Accepting new patients

Locations

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

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

2540 Centreville Rd
Centreville, MD 21617
Phone (410) 758-4432

2900 Mercy Ln
Cheverly, MD 20785
Phone (301) 618-2010

219 S Washington St
Easton, MD 21601

900 Elkridge Landing Rd
Fl 2
Linthicum Heights, MD 21090
Phone (443) 462-5010

Interoperability endpoints

  • Direct secure messaging: etekle1242241@direct.umm.edu
  • Direct secure messaging: etekle134243@direct.hopkinsmedicine.org

Organizations & group practices 12

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": "1304467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304467200000",
    "number": "1770875122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64522",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 LINDEN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212014606",
            "telephone_number": "410-225-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEKLE",
        "first_name": "ESAYAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-04",
        "last_updated": "2011-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0004355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.