Individual provider Active NPI

Malefiya Gashaw Kenea, FNP

  • Family Nurse Practitioner
  • Washington, DC
National Provider Identifier
1982312195
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP1056220 Issued in DC
Practice address
5140 Nannie Helen Burroughs Ave NE
Washington, DC 20019-5509
Phone
(917) 703-6786
NPI assigned
Nov 8, 2022
Last updated
Oct 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP1056220 DC Primary

Addresses

Primary practice location

5140 Nannie Helen Burroughs Ave NE
Washington, DC 20019-5509

Mailing address

1332 Chapel Centre Dr
Gambrills, MD 21054-1978
Phone (917) 703-6786

Other names 1

  • Malefiya Kenea Madessa Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 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

Enrollment IDStateProvider typePAC IDDetails
I20230106000970 DC Practitioner - Nurse Practitioner 3870963986 Reassigns benefits to 1 organization
I20250411000585 MD Practitioner - Nurse Practitioner 3870963986 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
Group practices
Healtopia Primary Care and Medical Weight Loss, LLCGroup PAC ID 3274056767, 2 clinicians

Practice addresses (Care Compare)

2614 Chapel Lake Dr
Gambrills, MD 21054-1637
Phone (786) 788-5080

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP1056220DCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healtopia Primary Care and Medical Weight Loss, LLC CurrentSince Feb 16, 2025 Accepting new patients
Mbi Health Services LLC CurrentSince Dec 21, 2022 Accepting new patients
Dyn Telehealth Clinic CurrentSince Dec 18, 2022 Accepting new patients
Omar F. Ahmad, M.D., P.C. PastSince Feb 16, 2025 Accepting new patients

Locations

4130 Hunt Pl NE
Washington, DC 20019
Phone (202) 388-4320

5140 Nannie Helen Burroughs Ave NE
Washington, DC 20019
Phone (202) 903-7611

7200 Wisconsin Ave
Ste 702
Bethesda, MD 20814
Phone (202) 215-5348

2614 Chapel Lake Dr
Gambrills, MD 21054
Phone (301) 893-3484

Interoperability endpoints

  • Direct secure messaging: malefiya.madessa@966419389808644.direct.elationemr.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": "1667865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1982312195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1332 CHAPEL CENTRE DR",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541978",
            "telephone_number": "917-703-6786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5140 NANNIE HELEN BURROUGHS AVE NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200195509",
            "telephone_number": "917-703-6786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENEA",
        "first_name": "MALEFIYA",
        "middle_name": "GASHAW",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-08",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DC",
            "license": "NP1056220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALEFIYA",
            "last_name": "MADESSA",
            "middle_name": "KENEA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.