Organization Active NPI

Yeheyis T. Negussie MD PC

  • Internal Medicine Physician
  • Silver Spring, MD
National Provider Identifier
1932310851
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0045471 Issued in MD
Legal business name
YEHEYIS T. NEGUSSIE MD PC
Practice address
8604 2ND Ave
Silver Spring, MD 20910-3326
Phone
(301) 565-3440
Fax
(301) 565-3455
NPI assigned
May 24, 2007
Last updated
Jun 16, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Yeheyis T. Negussie, M.D.NPI 1831122647
Title
Owner
Phone
(301) 565-3440

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0045471 MD Primary

Addresses

Primary practice location

8604 2ND Ave
Silver Spring, MD 20910-3326

Mailing address

13136 Brushwood Way
Potomac, MD 20854-1025
Phone (301) 565-3440

Other identifiers 2

IdentifierTypeStateIssuer
026730200MedicaidDC
200300700MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100520000844 DC Part B Supplier - Clinic/Group Practice 3274662747 Receives reassigned benefits from 1 practitioner
Practice locations: Silver Spring, MD

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D0998024Yeheyis Negussie MD PC8604 2ND Avenue, Silver Spring, MD 20910Certificate of waiverApr 2, 2028

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1932310851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13136 BRUSHWOOD WAY",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208541025",
            "telephone_number": "301-565-3440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8604 2ND AVE",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209103326",
            "telephone_number": "301-565-3440",
            "fax_number": "301-565-3455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YEHEYIS T. NEGUSSIE MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "NEGUSSIE",
        "authorized_official_first_name": "YEHEYIS",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-565-3440",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0045471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026730200",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200300700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.