NPIMap

Organization Active NPI

Mulai T Yohannes MD PCCS Medical LLC

  • Pulmonary Disease Physician
  • Lanham, MD
National Provider Identifier
1780013508
Registry record updated Nov 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MD32123 Issued in DC
Legal business name
MULAI T YOHANNES MD PCCS MEDICAL LLC
Practice address
9801 Greenbelt Rd
Suite 101
Lanham, MD 20706-2273
Phone
(301) 552-6666
Fax
(301) 552-6216
NPI assigned
Nov 2, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2013

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

Authorized official

Name
Dr. Mulai T Yohannes, M.D.NPI 1942217781
Title
Sole Member
Phone
(301) 552-6666

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X MD32123 DC
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X MD32123 DC Primary
Sleep Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RS0012X D0059094 MD

Addresses

Primary practice location

9801 Greenbelt Rd
Suite 101
Lanham, MD 20706-2273

Mailing address

PO Box 2344
Arlington, VA 22202-0344
Phone (301) 552-6666

Other identifiers 2

IdentifierTypeStateIssuer
5099242 00MedicaidMD
1334424OtherAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131206000684 DC Part B Supplier - Clinic/Group Practice 6406083088 Receives reassigned benefits from 1 practitioner
Practice locations: Clinton, MD; Silver Spring, MD; Lanham, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1383350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383350400000",
    "number": "1780013508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2344",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222020344",
            "telephone_number": "301-552-6666",
            "fax_number": "301-552-6216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9801 GREENBELT RD",
            "address_2": "SUITE 101",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207062273",
            "telephone_number": "301-552-6666",
            "fax_number": "301-552-6216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MULAI T YOHANNES MD PCCS MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-02",
        "last_updated": "2013-11-02",
        "status": "A",
        "authorized_official_last_name": "YOHANNES",
        "authorized_official_first_name": "MULAI",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "301-552-6666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "DC",
            "license": "MD32123",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "DC",
            "license": "MD32123",
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "MD",
            "license": "D0059094",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5099242 00",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1334424",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lanham, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.