Yared Tekle

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

License

R189003 Issued in MD

Practice address

3923 Dunes Way
Burtonsville, MD 20866-1375

Phone

(240) 421-1204

NPI assigned

Mar 6, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Supportive Care of Maryland LLCGroup PAC ID 9234460999, 38 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.29 of 100Reported as group

Quality

73.37

Improvement activities

40

Cost

83.13

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Supportive Care of Maryland LLC

  • Psychologist
  • Riverdale, MD
  • NPI 1447802616

  DC

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1646524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646524800000",
    "number": "1922755354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3923 DUNES WAY",
            "city": "BURTONSVILLE",
            "state": "MD",
            "postal_code": "208661375",
            "telephone_number": "240-421-1204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3923 DUNES WAY",
            "city": "BURTONSVILLE",
            "state": "MD",
            "postal_code": "208661375",
            "telephone_number": "240-421-1204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEKLE",
        "first_name": "YARED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-06",
        "last_updated": "2022-03-06",
        "certification_date": "2022-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "MD",
            "license": "R189003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haddy Tambadou, LGPC
• Dorothy Kembong Taylor
• Geraldine Tchakam
• Rachel Tchaya Kouamen
• Gisele Tchouga
• Wubeshet Tesema
• The Center for Adoption Support & Education, Inc.
• Therapeutic Superventions, Inc.
• Thrive PT LLC
• Simon A Tiku

• Adult Psychiatric/Mental Health Registered Nurse in Burtonsville, MD
• Providers in Burtonsville, MD by specialty
• Adult Psychiatric/Mental Health Registered Nurse in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.