TEWOBESTA FESSEHA TESFAYE MD
NPI 1124968789
Student in an Organized Health Care Education/Training Program in Gainesville, GA

Q: What is Tewobesta Tesfaye's NPI number?

The NPI number for Tewobesta Tesfaye is 1124968789. It was assigned to this individual provider in the NPPES registry on March 31, 2026.

Q: What is Tewobesta Tesfaye's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Tewobesta Tesfaye was last updated on March 31, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since March 31, 2026PECOS Enrolled

1439 JESSE JEWELL PKWY NE STE 202, GAINESVILLE, GA 30501(770) 219-9675(770) 219-9676 Get Directions Write a Review

NPPES record last updated: March 31, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Tewobesta Fesseha Tesfaye Md NPPES

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

TEWOBESTA FESSEHA TESFAYE MD (NPI 1124968789) is an individual student in an organized health care education/training program in Gainesville, Georgia and active in the NPI registry since March 2026. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124968789

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameTEWOBESTA FESSEHA TESFAYECredential: MD

Location Address1439 JESSE JEWELL PKWY NE STE 202Gainesville, GA 30501-3806

Mailing Address743 Spring St Ne Ste 710Gainesville, GA 30501-3715 · (770) 219-8730

Phone(770) 219-9675

Fax(770) 219-9676

Sole ProprietorNo

Enumeration DateMarch 31, 2026

NPPES CertifiedMarch 31, 2026

✔ NPI 1124968789 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1439 JESSE JEWELL PKWY NE STE 202, Gainesville, GA 30501

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tewobesta Fesseha Tesfaye Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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Other Providers at the Same Location NPPES 20

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

CAMERON JEFFERY CHAPPELL DO

Student in an Organized Health Care Education/Training Program