Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Eugide Kasongo Othepa, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1639819212

Dr. Eugide Kasongo Othepa, MD is a Family Practice in Berlin, Maryland. Qualified in 2019, 7 years ago. Practices with Tidalhealth Atlantic Inc, a 96-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Maryland.

Years since qualifying
7
Licensed in
MD
In the registry since
2022
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

10614 Racetrack Rd Unit 5
Berlin, MD 21811-3383
Phone: (410) 208-9761
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 7045 Antebellum Way, Frederick, MD 21703-7479 — (571) 458-9569

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence D0102990 (MD)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1639819212
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMarch 31, 2022
Last updated in NPPESJuly 9, 2025
Certification dateJuly 9, 2025
Mailing address7045 Antebellum Way, Frederick, MD 21703-7479

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Tidalhealth Atlantic Inc — 96 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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