| Ennoble HC Dmv III LLC | |
|
962 Wayne Ave Ste 250 Silver Spring MD 20910-4433 | |
| (240) 744-0001 | |
| Not Available |
| Full Name | Ennoble HC Dmv III LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 962 Wayne Ave Ste 250, Silver Spring, Maryland |
| Authorized Official Name and Position | Kushabhadra Das (CEO) |
| Authorized Official Contact | 8628129010 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ennoble HC Dmv III LLC 2 University Plz Ste 204 Hackensack NJ 07601-6211 Ph: (551) 295-8223 | Ennoble HC Dmv III LLC 962 Wayne Ave Ste 250 Silver Spring MD 20910-4433 Ph: (240) 744-0001 |
| NPI Number | 1922981695 |
|---|---|
| Provider Enumeration Date | 07/29/2025 |
| Last Update Date | 11/03/2025 |
| Certification Date | 11/03/2025 |
| Medicare PECOS PAC ID | 5092205856 |
|---|---|
| Medicare Enrollment ID | O20251110001045 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922981695 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | (NU) | Primary |
| Provider Name | Sandra Casey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548293475 PECOS PAC ID: 2860496775 Enrollment ID: I20060907000488 |
| Provider Name | Menbere Bahru |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528130218 PECOS PAC ID: 4789787284 Enrollment ID: I20070320000694 |
| Provider Name | Rajdeep Parmar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518939008 PECOS PAC ID: 1456445196 Enrollment ID: I20070926000366 |
| Provider Name | Rahel G Yirga |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437121910 PECOS PAC ID: 2365536000 Enrollment ID: I20070926000766 |
| Provider Name | James R Eskew |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1114915592 PECOS PAC ID: 6406988484 Enrollment ID: I20100727000806 |
| Provider Name | Maria Read |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588877609 PECOS PAC ID: 9739341801 Enrollment ID: I20121116000233 |
| Provider Name | Katherine Archut |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548661283 PECOS PAC ID: 5698997286 Enrollment ID: I20141114002309 |
| Provider Name | Kristen E Dickert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477949758 PECOS PAC ID: 2062732241 Enrollment ID: I20151201001649 |
| Provider Name | Karen Marshall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841413762 PECOS PAC ID: 6800159187 Enrollment ID: I20180419001688 |
| Provider Name | Dana L Colvin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386163475 PECOS PAC ID: 6305191362 Enrollment ID: I20180614001490 |
| Provider Name | Hanna Tokon-yilma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508217498 PECOS PAC ID: 3274811765 Enrollment ID: I20200224000480 |
| Provider Name | Cierra Jade Relyea |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669083416 PECOS PAC ID: 3274952676 Enrollment ID: I20201007002578 |
| Provider Name | Hermon Mesfin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760157374 PECOS PAC ID: 9739577545 Enrollment ID: I20211028000416 |
| Provider Name | Ashleigh Wallace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881369536 PECOS PAC ID: 4587053152 Enrollment ID: I20211119002176 |
| Provider Name | Sjamer Chere |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659922854 PECOS PAC ID: 8921405085 Enrollment ID: I20220124002764 |
| Provider Name | Phanta Jah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174296461 PECOS PAC ID: 1153714308 Enrollment ID: I20220210001521 |
| Provider Name | Ivan H Racadag |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083062392 PECOS PAC ID: 0648568121 Enrollment ID: I20221014000233 |
| Provider Name | Concilia Mbawuike |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336837574 PECOS PAC ID: 8022474428 Enrollment ID: I20230509002154 |
| Provider Name | Christina Pritchard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538851704 PECOS PAC ID: 4385002740 Enrollment ID: I20230619000173 |
| Provider Name | Theresa Juana Kamanda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750096962 PECOS PAC ID: 3072974492 Enrollment ID: I20230802001050 |
| Provider Name | Anna Dinello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982466348 PECOS PAC ID: 7719323153 Enrollment ID: I20240307004307 |
| Provider Name | Nermala Vasu Diven |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497330344 PECOS PAC ID: 1355780750 Enrollment ID: I20240418001138 |
| Provider Name | Dona Zainab Conteh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578314423 PECOS PAC ID: 0547703712 Enrollment ID: I20240616000078 |
| Provider Name | Warnakulasuriya Lowe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417661257 PECOS PAC ID: 5991245581 Enrollment ID: I20240910002647 |
| Provider Name | Eline Patricia Narcisse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306690607 PECOS PAC ID: 7315479664 Enrollment ID: I20241011002284 |
| Provider Name | Mesfin Wanna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548981004 PECOS PAC ID: 8729463161 Enrollment ID: I20250203000356 |
| Provider Name | Linda Firth |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1477690832 PECOS PAC ID: 2365680931 Enrollment ID: I20250226000479 |
| Provider Name | Jackson Son |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265291272 PECOS PAC ID: 5496275877 Enrollment ID: I20250228001889 |
| Provider Name | Kadiatu Kamara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992542625 PECOS PAC ID: 7810418167 Enrollment ID: I20250304001034 |
| Provider Name | Lauren M Tracy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790436749 PECOS PAC ID: 2668867599 Enrollment ID: I20250404001172 |
| Provider Name | Renee Brack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790293215 PECOS PAC ID: 5193087252 Enrollment ID: I20250409002546 |
| Provider Name | Rebecca Mensah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194504068 PECOS PAC ID: 9830686195 Enrollment ID: I20251017002574 |
| Provider Name | Charbene Olugbemi |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1598473043 PECOS PAC ID: 4486198058 Enrollment ID: I20260108000196 |
| Provider Name | Lael Little |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730494980 PECOS PAC ID: 1759560279 Enrollment ID: I20260112001156 |
| Provider Name | Mark Bradshaw |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316107428 PECOS PAC ID: 6608049275 Enrollment ID: I20260121002348 |
| Provider Name | Sara Dunne |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1053671859 PECOS PAC ID: 1355597188 Enrollment ID: I20260203003995 |
| Provider Name | Isaac Esene |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1194411801 PECOS PAC ID: 6901380070 Enrollment ID: I20260319001258 |
| Provider Name | Sabik Sadiq |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669059648 PECOS PAC ID: 0749783975 Enrollment ID: I20260401002601 |
| Provider Name | Julie Richitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700734134 PECOS PAC ID: 3072081371 Enrollment ID: I20260505003497 |
| Provider Name | Tiffany Leigh Henry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386450187 PECOS PAC ID: 3476024928 Enrollment ID: I20260604003974 |
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Somatus Maryland Home Training Center, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8380 Colesville Rd Ste 100a, Silver Spring, MD 20910 Phone: 855-851-8354 |
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Sunitha Bhogavilli, MD PC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9801 Georgia Ave, Suite 117, Silver Spring, MD 20902 Phone: 301-570-9700 Fax: 301-260-2838 |
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