Individual provider Active NPI

Teizu Wolokolie, M.D.

  • Internal Medicine Physician
  • Berlin, MD
National Provider Identifier
1841240108
Registry record updated Mar 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
32195 Issued in AZ
Practice address
9715 Healthway Dr
Berlin, MD 21811-3500
Phone
(443) 548-5700
Fax
(443) 548-5705
NPI assigned
May 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2016

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 32195 AZ Primary

Addresses

Primary practice location

9715 Healthway Dr
Berlin, MD 21811-3500

Mailing address

9715 Healthway Dr
Berlin, MD 21811-3500
Phone (443) 548-5700

Other identifiers 1

IdentifierTypeStateIssuer
825838-01MedicaidAZ

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: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120406000202 MD Practitioner - Internal Medicine 0648166363 Reassigns benefits to 1 organization
I20120406000243 DC Practitioner - Internal Medicine 0648166363 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Five Star Physician Services, LLC Internal Medicine CurrentSince Apr 1, 2012 Accepting new patients
Hospitalists of Arizona, Inc Internal Medicine Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

9715 Healthway Dr
Berlin, MD 21811
Phone (410) 641-4400

8700 Jones Mill Rd
Chevy Chase, MD 20815
Phone (301) 350-5555

785 Elkridge Landing Rd
Ste 300
Linthicum Heights, MD 21090
Phone (443) 323-3014

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457654400000",
    "number": "1841240108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9715 HEALTHWAY DR",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218113500",
            "telephone_number": "443-548-5700",
            "fax_number": "443-548-5705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9715 HEALTHWAY DR",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218113500",
            "telephone_number": "443-548-5700",
            "fax_number": "443-548-5705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLOKOLIE",
        "first_name": "TEIZU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2016-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "32195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "825838-01",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, MD

Sources for this page

Verify at the official NPI Registry.