BERHANU EJIGU KEDEDA NP-C
NPI 1184994105
Nurse Practitioner - Family in Tucker, GA
About Berhanu Ejigu Kededa Np-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BERHANU EJIGU KEDEDA NP-C (NPI 1184994105) is an individual family provider in Tucker, Georgia, licensed in Georgia (RN152429) and active in the NPI registry since January 2012. He is enrolled in Medicare PECOS and is a graduate of Other (2018).
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Group Practice 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
Berhanu Ejigu Kededa Np-c 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
6Medicare enrollment records show Berhanu Kededa reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Decatur, GA 30033
- Reassigned Medicare billing, Georgia enrollment
- 128 clinicians in this Medicare group
Lawrenceville, GA 30046
- Reassigned Medicare billing, Georgia enrollment
- 275 clinicians in this Medicare group
Peachtree City, GA 30269
- Reassigned Medicare billing, Oregon enrollment
- 16 clinicians in this Medicare group
Lanham, MD 20706
- Reassigned Medicare billing, Oregon enrollment
- 43 clinicians in this Medicare group
Portland, OR 97220
- Reassigned Medicare billing, Oregon enrollment
- 48 clinicians in this Medicare group
Bellevue, WA 98004
- Reassigned Medicare billing, Oregon enrollment
- 46 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.
Areas of Expertise CMS Part B claims 8
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 30084 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
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 Berhanu Kededa's NPI number?
The NPI number for Berhanu Kededa is 1184994105. It was assigned to this individual provider in the NPPES registry on January 6, 2012. The provider is also known as Berhanu Kedida Ejigu Np-C.
Where is Berhanu Kededa located?
Berhanu Kededa practices at 5576 Princeton Run Trl, Tucker, GA 30084. The listed phone number is (678) 793-8808.
What is Berhanu Kededa's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Berhanu Kededa enrolled in Medicare?
Yes. Berhanu Kededa 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 Berhanu Kededa's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Berhanu Kededa reassigns Medicare benefits to 6 organizations: Cep America LLC (Decatur, GA), Gwinnett Physician Group, LLC (Lawrenceville, GA), Impact Physician Group, LLC (Peachtree City, GA), Post Acute Medical PLLC (Lanham, MD), Altea Medical Oregon LLC (Portland, OR) and 1 more organization, listed in the Medicare section above. 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 Berhanu Kededa's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Berhanu Kededa accept?
Health plans from BridgeSpan Health Company, Providence Health Plan and Regence BlueCross BlueShield of Oregon list Berhanu Kededa 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.
When was this NPI record last updated?
The NPPES record for Berhanu Kededa was last updated on October 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.
# Berhanu Ejigu Kededa, NP-C · NPI 1184994105
Family physician in Tucker, Georgia. Individual provider, active in the CMS NPPES registry since January 6, 2012.
## Identity
- **NPI:** 1184994105 (Entity type: Individual)
- **Enumerated:** January 6, 2012
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** RN152429 (Georgia)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 5576 PRINCETON RUN TRL, Tucker, GA 30084-8463
- **Phone:** (678) 793-8808
## 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:** 6 organizations under Medicare reassignment (form CMS-855R): Cep America LLC (NPI 1215982814, Decatur, GA); Gwinnett Physician Group, LLC (NPI 1578574661, Lawrenceville, GA); Impact Physician Group, LLC (NPI 1114428612, Peachtree City, GA); Post Acute Medical PLLC (NPI 1730713025, Lanham, MD); Altea Medical Oregon LLC (NPI 1184451254, Portland, OR); and 1 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2018
## Record status
- **NPPES last updated:** October 9, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1184994105) · Data from the CMS NPPES public registry.