Kwasi A Debra, MD

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

D0040683 Issued in MD

Practice address

12200 Annapolis Rd
Ste 123
Glenn Dale, MD 20769-9182

Phone

(301) 552-9495

Fax

(301) 552-9743

NPI assigned

Aug 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 6

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/GynecologyAlso: Family Practice

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Maryland Specialty Group LLC

  • Vascular Surgery Physician
  • Glenn Dale, MD
  • NPI 1114362845

  DC

  Medicare reassignment
• Maryland Specialty Group LLC

  • Obstetrics & Gynecology Physician
  • Glenn Dale, MD
  • NPI 1023157781
  NPD
• Cignet Health Uplift Medical

  • Multi-Specialty Clinic/Center
  • Temple Hills, MD
  • NPI 1053475749
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Central VA OB GYN Associates

  • Obstetrics & Gynecology Physician
  • Richmond, VA
  • NPI 1326139031
  NPD (past)
• John Randolph OB/GYN, LLC

  • Obstetrics & Gynecology Physician
  • Richmond, VA
  • NPI 1720117559
  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1972512408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12200 ANNAPOLIS RD",
            "address_2": "STE 123",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207699182",
            "telephone_number": "301-552-9495",
            "fax_number": "301-552-9743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 ANNAPOLIS RD",
            "address_2": "STE 123",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207699182",
            "telephone_number": "301-552-9495",
            "fax_number": "301-552-9743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBRA",
        "first_name": "KWASI",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "MD",
            "license": "D0040683",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "DC",
            "license": "MD20163",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1026004806",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "925694",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "H9050001",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST  BC BS OF MD",
            "identifier": "52507102",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4561470",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "703633",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sherri Crable, PT, DPT
• Denise C Crarey
• CVC Healthcare Inc
• Nader A Dakak, M.D.
• Cynthia Yvonne Dawkins
• Jameice Decoster-Edmunds, PSYD
• Robert Henry Dennis II, M.D.
• Desiree Clemence Deutchoua, HHA
• Nadege Djiefack
• DMV Psychiatric Wellness, LLC

• Gynecology Physician in Glenn Dale, MD
• Providers in Glenn Dale, MD by specialty
• Gynecology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2017; 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.