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NEBIYU ABIY ESHETU M.D.
NPI 1407275357
Hospitalist in Baltimore, MD

Active since April 08, 2014PECOS EnrolledAccepts Medicare Assignment
62.91/100
CMS Quality Rating
1124 MACE AVE, BALTIMORE, MD 21221(410) 391-6996(410) 687-6877 Get Directions Write a Review

NPPES record last updated: May 21, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 21, 2025, Mar 17, 2018, Feb 28, 2018 and 2 more (5 updates tracked since 2017).

About Nebiyu Abiy Eshetu M.d. NPPES

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

NEBIYU ABIY ESHETU M.D. (NPI 1407275357) is an individual hospitalist provider in Baltimore, Maryland, licensed in Missouri (2021011710) and active in the NPI registry since April 2014. He is enrolled in Medicare PECOS, is affiliated with Ssm Health Saint Louis University Hospital, and maintains a secondary practice location in York.

NPPES Registry Identity

NPI1407275357
Entity TypeIndividualMale
Primary Taxonomy208M00000X
Provider Legal NameNEBIYU ABIY ESHETUCredential: M.D.
Location Address1124 MACE AVEBaltimore, MD 21221-3315
Mailing Address1124 Mace AveBaltimore, MD 21221-3315 · (410) 391-6996 · Fax (410) 687-6877
Phone(410) 391-6996
Fax(410) 687-6877
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateApril 8, 2014
Last NPPES UpdateMay 21, 20255 updates tracked since enumeration
NPPES CertifiedMay 21, 2025
✔ NPI 1407275357 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
License✔ Licensed in MO · 2021011710
Definition
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
Also ListedInternal MedicineTaxonomy 207R00000X · License MD460824 (PA), D0084914 (MD)
1124 MACE AVE, Baltimore, MD 21221
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Other Names 1

Other Name (5)Nebiyu Abiy

Secondary Practice Location 1

Location 11001 S George St Fl 4York, PA 17403-3676 · Phone (717) 851-4005 · Fax (717) 812-2495

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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

Nebiyu Abiy Eshetu M.d. 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 ID6901176361
PECOS Enrollment IDI20210812000229
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 Nebiyu Eshetu reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ssm Health Care Group
742 mi
Internal Medicine
1225 SOUTH GRAND BLVD, 2L - DOOR 3,4
Saint Louis, MO 63104
  • Reassigned Medicare billing, Missouri enrollment
  • 1,294 clinicians in this Medicare group
NPI 1306589544 (314) 977-6100
P & c Healthcare LLC
958 mi
Hospitalist
19600 E 39TH ST S
Independence, MO 64057
  • Reassigned Medicare billing, Missouri enrollment
  • 71 clinicians in this Medicare group
NPI 1124575923 (913) 222-9779

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 7

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
198 services83 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
52 services27 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
33 services17 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
31 services31 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
26 services26 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
21 services20 patients

Hospital Affiliations CMS Care Compare

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

Ssm Health Saint Louis University Hospital

Acute Care Hospitals · Saint Louis, MO
1/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number260105
Location3635 Vista AveSaint Louis, MO 63110 · St. Louis City County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 21221 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
$139.05 typical visit price
range $60.73 – $183.44
Typical copayment $34.76 (range $15.18 – $45.86)
Most-billed visit code 99204
Established Patient
$106.59 typical visit price
range $19.60 – $149.17
Typical copayment $26.64 (range $4.90 – $37.29)
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.

62.91/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality71.07
Improvement Activities0
Cost53.61

Reported Quality Measures

Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
99%1,211 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
61%1,061 patients3/55-star benchmark: 100%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
9%193 patients1/55-star benchmark: 98%
Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antiplatelet
Percentage of patients 18 years of age and older who were diagnosed with acute myocardial infarction (AMI), coronary artery bypass graft (CABG) or percutaneous coronary interventions (PCI) in the 12 months prior to the measurement period, or who had an active…
92%25 patients4/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
88%48 patients4/55-star benchmark: 100%
Medication Reconciliation Post-Discharge
The percentage of discharges from any inpatient facility (e.g. hospital, skilled nursing facility, or rehabilitation facility) for patients 18 years and older of age seen within 30 days following discharge in the office by the physician, prescribing…
Patients 65+: 100% · 36 patients
100%41 patients
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
5%371 patients1/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
78%787 patients4/55-star benchmark: 100%
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling
Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user
94%313 patients4/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
88%371 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
33%371 patients2/55-star benchmark: 79%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
3 suppliers48 claims48 services$14.77 avg. paid by Medicare
Residual limb support system for wheelchair, any type E1020
DME-Wheelchairs · category DD021N
1 supplier11 claims11 services$11.43 avg. paid by Medicare
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning accessory E1028
DME-Wheelchairs · category DD021N
1 supplier12 claims12 services$8.96 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
5 suppliers67 claims67 services$67.66 avg. paid by Medicare
Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds K0825
DME-Wheelchairs · category DD009N
1 supplier12 claims12 services$172.78 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

CHUKWUMA EBO,M.D.,PA
Internal Medicine
1124 MACE AVE
BALTIMORE, MD 21221
Baltimore County (410) 391-6996
JOHN J LOH ,D. O.,P A
Internal Medicine
1124 MACE AVE
BALTIMORE, MD 21221
Baltimore County (410) 391-6996
DR. KAMAL ALEXANDER HAMOD M.D.
Obstetrics & Gynecology
1124 MACE AVE
ESSEX, MD 21221
Baltimore County (410) 847-3500
SAVITHA SHIVANANDA
Internal Medicine
1124 MACE AVE
BALTIMORE, MD 21221
Baltimore County (410) 391-6996
MACE MEDICAL LLC
Internal Medicine
1124 MACE AVE
ESSEX, MD 21221
Baltimore County (410) 391-6996
OLOLADE IKUOMOLA NP-C
Nurse Practitioner (Primary Care)
1124 MACE AVE
BALTIMORE, MD 21221
Baltimore County (410) 391-6996
LAUREN LOKEY MSN, FNP-C
Nurse Practitioner (Family)
1124 MACE AVE
BALTIMORE, MD 21221
Baltimore County (104) 391-6996
GANESH TAMANG NP
Nurse Practitioner
1124 MACE AVE
ESSEX, MD 21221
Baltimore County (410) 391-6996

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 Nebiyu Eshetu's NPI number?

The NPI number for Nebiyu Eshetu is 1407275357. It was assigned to this individual provider in the NPPES registry on April 8, 2014. The provider is also known as Nebiyu Abiy.

Where is Nebiyu Eshetu located?

Nebiyu Eshetu practices at 1124 Mace Ave, Baltimore, MD 21221. The listed phone number is (410) 391-6996.

What is Nebiyu Eshetu's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is Nebiyu Eshetu enrolled in Medicare?

Yes. Nebiyu Eshetu 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 Nebiyu Eshetu's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nebiyu Eshetu reassigns Medicare benefits to 2 organizations: Ssm Health Care Group (Saint Louis, MO) and P & c Healthcare LLC (Independence, MO). 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 Nebiyu Eshetu's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Nebiyu Eshetu accept?

Health plans from Anthem Blue Cross and Blue Shield list Nebiyu Eshetu 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 Nebiyu Eshetu affiliated with any hospitals?

According to CMS data, Nebiyu Eshetu is affiliated with Ssm Health Saint Louis University Hospital.

When was this NPI record last updated?

The NPPES record for Nebiyu Eshetu was last updated on May 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.