ESUBALEW MINDAYE
NPI 1124983291
Student in an Organized Health Care Education/Training Program in Trenton, NJ

Active since December 19, 2025PECOS EnrolledAccepts Medicare Assignment
750 BRUNSWICK AVENEU, TRENTON, NJ 08638(609) 394-6031 Get Directions Write a Review

NPPES record last updated: June 4, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 4, 2026, May 15, 2026, Dec 19, 2025 (3 updates tracked since 2025).

About Esubalew Mindaye NPPES

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

ESUBALEW MINDAYE (NPI 1124983291) is an individual student in an organized health care education/training program in Trenton, New Jersey and active in the NPI registry since December 2025. He is enrolled in Medicare PECOS, maintains a secondary practice location in Bellingham, and is a graduate of Other (2004).

NPPES Registry Identity

NPI1124983291
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameESUBALEW MINDAYE
Location Address750 BRUNSWICK AVENEUTrenton, NJ 08638
Mailing Address750 Brunswick AveTrenton, NJ 08638-4143 · (609) 394-6031
Sole ProprietorNo
Medical School CMSOtherGraduated 2004
Enumeration DateDecember 19, 2025
Last NPPES UpdateJune 4, 20263 updates tracked since enumeration
NPPES CertifiedJune 4, 2026
✔ NPI 1124983291 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

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.
Also ListedInternal MedicineTaxonomy 207R00000X · License MDCE.ML.70053971 (WA)
750 BRUNSWICK AVENEU, Trenton, NJ 08638

Secondary Practice Location 1

Location 12219 Rimland Dr Ste 301Bellingham, WA 98226-8759 · Phone (832) 776-3603

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

Esubalew Mindaye 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.

PECOS PAC ID7517448079
PECOS Enrollment IDI20260223002046
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Esubalew Mindaye reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Geriatric Medicine
6710 MALLERY DR
Lanham, MD 20706
  • Reassigned Medicare billing, Washington enrollment
  • 239 clinicians in this Medicare group
Geriatric Medicine
7024 EVERGREEN WAY STE A
Everett, WA 98203
  • Reassigned Medicare billing, Washington enrollment
  • 166 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.

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 Esubalew Mindaye's NPI number?

The NPI number for Esubalew Mindaye is 1124983291. It was assigned to this individual provider in the NPPES registry on December 19, 2025.

Where is Esubalew Mindaye located?

Esubalew Mindaye practices at 750 Brunswick Aveneu, Trenton, NJ 08638. The listed phone number is (609) 394-6031.

What is Esubalew Mindaye's specialty?

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

Is Esubalew Mindaye enrolled in Medicare?

Yes. Esubalew Mindaye 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 Esubalew Mindaye's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Esubalew Mindaye reassigns Medicare benefits to 2 organizations: Post Acute Medical PLLC (Lanham, MD) and Altea Medical Washington PLLC (Everett, WA). 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 Esubalew Mindaye's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Esubalew Mindaye was last updated on June 4, 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.