HERAN MENGESHA
NPI 1295198349
Internal Medicine in Nashville, TN

Q: What is Heran Mengesha's NPI number?

The NPI number for Heran Mengesha is 1295198349. It was assigned to this individual provider in the NPPES registry on April 5, 2016.

Q: What is Heran Mengesha's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Heran Mengesha was last updated on November 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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 April 05, 2016PECOS EnrolledAccepts Medicare Assignment

89.57/100

CMS Quality Rating

1005 DR DB TODD JR BLVD, NASHVILLE, TN 37208(615) 327-6000 Get Directions Write a Review

NPPES record last updated: November 27, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Heran Mengesha NPPES

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

HERAN MENGESHA (NPI 1295198349) is an individual internal medicine provider in Nashville, Tennessee, licensed in Tennessee (59931) and active in the NPI registry since April 2016. She is enrolled in Medicare PECOS, is affiliated with Sumner Regional Medical Center, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1295198349

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameHERAN MENGESHA

Location Address1005 DR DB TODD JR BLVDNashville, TN 37208-3501

Mailing Address1005 Dr Db Todd Jr BlvdNashville, TN 37208-3501 · (615) 327-6000

Phone(615) 327-6000

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateApril 5, 2016

Last NPPES UpdateNovember 27, 2023

✔ NPI 1295198349 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in TN · 59931

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

1005 DR DB TODD JR BLVD, Nashville, TN 37208

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Other Identifiers 1

MedicaidQ043041TN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Heran Mengesha 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 ID3678906203

PECOS Enrollment IDI20191211003336

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.

Areas of Expertise CMS Part B claims

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

16 services12 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Sumner Regional Medical Center

Acute Care Hospitals · Gallatin, TN

1/5 CMS rating

OwnershipProprietary

CMS Certification Number440003

Location555 Hartsville PikeGallatin, TN 37066 · Sumner County

Emergency services Birthing friendly

Ascension Saint Thomas Hospital

Acute Care Hospitals · Nashville, TN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number440082

Location4220 Harding Rd, PO Box 380Nashville, TN 37205 · Davidson County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37208 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$121.80 typical visit price

range $52.64 – $160.89

Typical copayment $30.45 (range $13.16 – $40.22)

Most-billed visit code 99204

Established Patient

$93.60 typical visit price

range $16.72 – $131.41

Typical copayment $23.40 (range $4.18 – $32.85)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

89.57/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

65.45

Promoting Interoperability

Improvement Activities

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.

MRS. TENE HAMILTON FRANKLIN M.S.

Genetic Counselor, MS

1005 DR DB TODD JR BLVD, MEHARRY SICKLE CELL CENTER
NASHVILLE, TN 37208

Davidson County (615) 327-6781

DR. SCOTTIE ABRAHAM BUSSELL MD,MPH

Preventive Medicine (Public Health & General Preventive Medicine)

1005 DR DB TODD JR BLVD
NASHVILLE, TN 37208

Davidson County (615) 327-6782

LYNDA I NTHIGA DO

Student in an Organized Health Care Education/Training Program

1005 DR DB TODD JR BLVD
NASHVILLE, TN 37208

Davidson County (615) 327-5547

DR. ESIRI ESIN M.D.

Psychiatry & Neurology (Psychiatry)

1005 DR DB TODD JR BLVD, MEHARRY MEDICAL COLLEGE
NASHVILLE, TN 37208

Davidson County (615) 327-6350

DR. WES EZRA SMOOT MD

Student in an Organized Health Care Education/Training Program

1005 DR DB TODD JR BLVD
NASHVILLE, TN 37208

Davidson County (615) 327-6350

DR. BINITA SATPATHY DDS

Dentist (General Practice)

1005 DR DB TODD JR BLVD
NASHVILLE, TN 37208

Davidson County (615) 327-6370

DR. ALLAN JOEL MEJIA PORTILLO MD

General Practice

1005 DR DB TODD JR BLVD
NASHVILLE, TN 37208

Davidson County (615) 327-6611

EFEMENA MICHAEL DIEJOMAOH MD

Psychiatry & Neurology (Psychiatry)

1005 DR DB TODD JR BLVD
NASHVILLE, TN 37208

Davidson County (615) 327-6350

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 Heran Mengesha's NPI number?

The NPI number for Heran Mengesha is 1295198349. It was assigned to this individual provider in the NPPES registry on April 5, 2016.

Where is Heran Mengesha located?

Heran Mengesha practices at 1005 Dr Db Todd Jr Blvd, Nashville, TN 37208. The listed phone number is (615) 327-6000.

What is Heran Mengesha's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Heran Mengesha enrolled in Medicare?

Yes. Heran Mengesha 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.

What insurance does Heran Mengesha accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of North Carolina and 2 other insurers list Heran Mengesha 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 Heran Mengesha affiliated with any hospitals?

According to CMS data, Heran Mengesha is affiliated with Sumner Regional Medical Center and Ascension Saint Thomas Hospital.

When was this NPI record last updated?

The NPPES record for Heran Mengesha was last updated on November 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.