Individual provider Active NPI

Banchayehu Gizaw, NP

  • Family Nurse Practitioner
  • Cheverly, MD
National Provider Identifier
1992345888
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R212879 Issued in MD
Practice address
3001 Hospital Dr
Cheverly, MD 20785-1189
Phone
(301) 618-2000
NPI assigned
Jan 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2020

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 R212879 MD Primary

Addresses

Primary practice location

3001 Hospital Dr
Cheverly, MD 20785-1189

Mailing address

1002 Chiswell LN
Silver Spring, MD 20901-1115

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
I20211006002917 DC Practitioner - Nurse Practitioner 9739587619 Reassigns benefits to 2 organizations
I20211006003145 MD Practitioner - Nurse Practitioner 9739587619 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Futurecare Rehabilitation Services IncGroup PAC ID 3072591999, 10 clinicians

Practice addresses (Care Compare)

8028 Ritchie Hwy
Suite 210
Pasadena, MD 21122-1075
Phone (410) 733-3292

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R212879MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Care LLC CurrentSince Nov 1, 2022 Accepting new patients
Premier Health Care, LLC CurrentSince Nov 1, 2022 Accepting new patients
Medical Maryland Star Choice LLC CurrentSince Mar 1, 2023 Accepting new patients

Locations

8023 Malcolm Rd
Clinton, MD 20735
Phone (301) 747-4364

5999 Harpers Farm Rd
Ste W230
Columbia, MD 21044
Phone (347) 294-5166

12073 Tech Rd
Ste B
Silver Spring, MD 20904
Phone (240) 396-5873

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1578441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1992345888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 CHISWELL LN",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209011115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 HOSPITAL DR",
            "city": "CHEVERLY",
            "state": "MD",
            "postal_code": "207851189",
            "telephone_number": "301-618-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIZAW",
        "first_name": "BANCHAYEHU",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-08",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R212879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheverly, MD

Sources for this page

Verify at the official NPI Registry.