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TIGIST WOLDEGEBRIAL HAILESELASSIE PA
NPI 1336681105
Physician Assistant - Medical in Laurel, MD

Active since November 10, 2016PECOS Enrolled
3357B CORRIDOR MARKETPLACE, LAUREL, MD 20724(301) 497-1820 Get Directions Write a Review

NPPES record last updated: December 2, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 2, 2025, Jul 8, 2025, Dec 9, 2020 and 1 more (4 updates tracked since 2016).

About Tigist Woldegebrial Haileselassie Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIGIST WOLDEGEBRIAL HAILESELASSIE PA (NPI 1336681105) is an individual medical provider in Laurel, Maryland, licensed in Maryland (C0006033) and active in the NPI registry since November 2016. She is enrolled in Medicare PECOS, maintains a secondary practice location in Greenbelt, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1336681105
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameTIGIST WOLDEGEBRIAL HAILESELASSIECredential: PA
Location Address3357B CORRIDOR MARKETPLACELaurel, MD 20724-2381
Mailing Address4903 Georgia Ave NwWashington, DC 20011-4525 · (202) 723-0393
Phone(301) 497-1820
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateNovember 10, 2016
Last NPPES UpdateDecember 2, 20254 updates tracked since enumeration
NPPES CertifiedDecember 2, 2025
✔ NPI 1336681105 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in MD · C0006033
3357B CORRIDOR MARKETPLACE, Laurel, MD 20724
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Secondary Practice Location 1

Location 17225 Hanover Pkwy, AGreenbelt, MD 20770-2024 · Phone (301) 345-1400

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tigist Woldegebrial Haileselassie Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4587091616
PECOS Enrollment IDI20200302000075, I20240304000371
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Testing for presence of drug, by chemistry analyzers 80307
Chemistry analyzers are used to detect the presence of drugs in your system. This test involves taking a small sample of your blood or urine. The sample is then analyzed for specific substances. The results help in understanding your health condition better.
47 services21 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
38 services21 patients

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNIFER BROWN PA-C
Physician Assistant
3357B CORRIDOR MARKETPLACE
LAUREL, MD 20724
Anne Arundel County (301) 497-1820
MR. YISROEL YEHOSHUA SCHONFELD PHYSICIAN ASSISTANT
Physician Assistant
3357B CORRIDOR MARKETPLACE
LAUREL, MD 20724
Anne Arundel County (301) 497-1820
MR. MANOUCHEHR ATAEI PA-C
Physician Assistant
3357B CORRIDOR MARKETPLACE
LAUREL, MD 20724
Anne Arundel County (301) 497-1820
JERRY A HUNTER M.D.
Internal Medicine
3357B CORRIDOR MARKETPLACE
LAUREL, MD 20724
Anne Arundel County (301) 497-5489
WENDY S CARR PA-C
Physician Assistant
3357B CORRIDOR MARKETPLACE
LAUREL, MD 20724
Anne Arundel County (301) 497-1820
ELLIOTT M. WHITKEN PA-C
Physician Assistant (Medical)
3357B CORRIDOR MARKETPLACE
LAUREL, MD 20724
Anne Arundel County (301) 497-1820
SHYLAJA UNNIKRISHNA KESHAV MD
Family Medicine
3357B CORRIDOR MARKETPLACE
LAUREL, MD 20724
Anne Arundel County (301) 497-1820
MOLLY ROSE PETERSCHMIDT PA-C
Physician Assistant
3357B CORRIDOR MARKETPLACE
LAUREL, MD 20724
Anne Arundel County (301) 497-1820

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tigist Haileselassie's NPI number?

The NPI number for Tigist Haileselassie is 1336681105. It was assigned to this individual provider in the NPPES registry on November 10, 2016.

Where is Tigist Haileselassie located?

Tigist Haileselassie practices at 3357B Corridor Marketplace, Laurel, MD 20724. The listed phone number is (301) 497-1820.

What is Tigist Haileselassie's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Tigist Haileselassie enrolled in Medicare?

Yes. Tigist Haileselassie is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Tigist Haileselassie was last updated on December 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.