Individual provider Active NPI

Eleanor Dzodzomenyo, CRNP, FNP-BC

  • Nurse Practitioner
  • Germantown, MD
National Provider Identifier
1942920202
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R205405 Issued in MD
Practice address
12800 Middlebrook Rd Ste 400
Germantown, MD 20874-5282
Phone
(301) 515-2901
NPI assigned
Aug 29, 2022
Last updated
Sep 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R205405 MD Primary

Addresses

Primary practice location

12800 Middlebrook Rd Ste 400
Germantown, MD 20874-5282

Mailing address

20410 Observation Dr Ste 100
Germantown, MD 20876-6419
Phone (301) 762-0277

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
I20231205002325 DC Practitioner - Nurse Practitioner 8820447618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Doctors First, LLCGroup PAC ID 3870661978, 58 clinicians

Practice addresses (Care Compare)

12800 Middlebrook Rd
Suite 400
Germantown, MD 20874-5282
Phone (301) 515-2901

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors First, LLC CurrentSince Oct 22, 2023 Accepting new patients
Doctors First, LLC CurrentSince Oct 22, 2023 Accepting new patients
American Diversity Group Inc Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

806 W Diamond Ave
Ste 110
Gaithersburg, MD 20878
Phone (240) 342-2407

12800 Middlebrook Rd
Ste 400
Germantown, MD 20874
Phone (240) 217-7794

19785 Crystal Rock Dr
Ste 209
Germantown, MD 20874
Phone (301) 528-8444

Interoperability endpoints

  • Direct secure messaging: eleanor.dzodzomenyo.1@4332.direct.athenahealth.com

Organizations & group practices 4

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": "1661731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789948800000",
    "number": "1942920202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20410 OBSERVATION DR STE 100",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208766419",
            "telephone_number": "301-762-0277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12800 MIDDLEBROOK RD STE 400",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208745282",
            "telephone_number": "301-515-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZODZOMENYO",
        "first_name": "ELEANOR",
        "credential": "CRNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-29",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R205405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, MD

Sources for this page

Verify at the official NPI Registry.