DR. EUGIDE KASONGO OTHEPA MD
NPI 1639819212
Family Medicine in Berlin, MD
About Dr. Eugide Kasongo Othepa Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. EUGIDE KASONGO OTHEPA MD (NPI 1639819212) is an individual family medicine provider in Berlin, Maryland, licensed in Maryland (D0102990) and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS, is affiliated with Tidalhealth Peninsula Regional, Inc, and maintains a secondary practice location in Frederick.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Eugide Kasongo Othepa Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Eugide Othepa reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Ocean City, MD 21842
- Reassigned Medicare billing, Maryland enrollment
- Medicare enrollment name: Tidalhealth Atlantic Inc
- 125 clinicians in this Medicare group
Salisbury, MD 21801
- Reassigned Medicare billing, Maryland enrollment
- 81 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Tidalhealth Peninsula Regional, Inc
Acute Care Hospitals · Salisbury, MDAtlantic General Hospital
Acute Care Hospitals · Berlin, MDPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 21811 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 5
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
BERLIN, MD 21811
BERLIN, MD 21811
BERLIN, MD 21811
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 Eugide Othepa's NPI number?
The NPI number for Eugide Othepa is 1639819212. It was assigned to this individual provider in the NPPES registry on March 31, 2022. The provider is also known as Dr. Eugide Kasongo-Othepa MD.
Where is Eugide Othepa located?
Eugide Othepa practices at 10614 Racetrack Rd Unit 5, Berlin, MD 21811. The listed phone number is (410) 208-9761.
What is Eugide Othepa's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Eugide Othepa enrolled in Medicare?
Yes. Eugide Othepa is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Eugide Othepa's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Eugide Othepa reassigns Medicare benefits to 2 organizations: Atlantic General Hospital Corp (Ocean City, MD) and Tidalhealth Primary Care, LLC (Salisbury, MD). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Eugide Othepa's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Eugide Othepa accept?
Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan and Highmark Blue Cross Blue Shield Delaware list Eugide Othepa as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Eugide Othepa affiliated with any hospitals?
According to CMS data, Eugide Othepa is affiliated with Tidalhealth Peninsula Regional, Inc and Atlantic General Hospital.
When was this NPI record last updated?
The NPPES record for Eugide Othepa was last updated on July 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.
# Dr. Eugide Kasongo Othepa, MD · NPI 1639819212
Family Medicine physician in Berlin, Maryland. Individual provider, active in the CMS NPPES registry since March 31, 2022.
## Identity
- **NPI:** 1639819212 (Entity type: Individual)
- **Enumerated:** March 31, 2022
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** D0102990 (Maryland)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 10614 RACETRACK RD UNIT 5, Berlin, MD 21811-3383
- **Phone:** (410) 208-9761
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Atlantic General Hospital Corp (NPI 1043756232, Ocean City, MD); Tidalhealth Primary Care, LLC (NPI 1104453208, Salisbury, MD) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2019
## Record status
- **NPPES last updated:** July 9, 2025
---
Source: [NPI Profile](https://npiprofile.com/npi/1639819212) · Data from the CMS NPPES public registry.