Individual provider Active NPI

Merate S Legesse, PA

  • Physician Assistant
  • Olney, MD
National Provider Identifier
1881635787
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0001510 Issued in MD
Practice address
18101 Prince Philip Drive
Montgomery General Hospital
Olney, MD 20832
Phone
(301) 774-8900
Fax
(301) 570-8574
NPI assigned
Jun 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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 C0001510 MD Primary

Addresses

Primary practice location

18101 Prince Philip Drive
Montgomery General Hospital
Olney, MD 20832

Mailing address

1300 Piccard Drive
Suite 202
Rockville, MD 20850-4303
Phone (301) 921-7900

Electronic endpoints 1

TypeEndpointUseAffiliation
RESTful URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20050426000205 DC Practitioner - Physician Assistant 3971542432 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

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

8008 Westpark Dr
MC Lean, VA 22102-3109
Phone (703) 287-6400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C0001510MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Mar 29, 2020 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Nov 27, 2017 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Nov 27, 2017 Accepting new patients
Mid-Atlantic Critical Care Services,L.L.C. Past Accepting new patients
Emergency Medicine Associates P.a., P.C. Past Accepting new patients

Locations

2101 E Jefferson St
Ste 6
Rockville, MD 20852

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

8008 Westpark Dr
Tysons Corner, VA 22102
Phone (703) 287-6400

Interoperability endpoints

  • Direct secure messaging: mlegesse158435@direct.hopkinsmedicine.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1881635787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 PICCARD DRIVE",
            "address_2": "SUITE 202",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208504303",
            "telephone_number": "301-921-7900",
            "fax_number": "301-921-7915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18101 PRINCE PHILIP DRIVE",
            "address_2": "MONTGOMERY GENERAL HOSPITAL",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "20832",
            "telephone_number": "301-774-8900",
            "fax_number": "301-570-8574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGESSE",
        "first_name": "MERATE",
        "middle_name": "S",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-10",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0001510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "REST",
            "endpointTypeDescription": "RESTful URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "18101 Prince Philip Drive",
            "address_2": "Montgomery General Hospital",
            "city": "Olney",
            "state": "MD",
            "country_code": "US",
            "postal_code": "20832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Olney, MD

Sources for this page

Verify at the official NPI Registry.