KASEBAOTH MEKONNEN
NPI 1467847855
Emergency Medicine in Oakland, CA
About Kasebaoth Mekonnen NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KASEBAOTH MEKONNEN (NPI 1467847855) is an individual emergency medicine provider in Oakland, California, licensed in Maryland (D87772) and active in the NPI registry since April 2015. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kasebaoth Mekonnen is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Kasebaoth Mekonnen reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Leesburg, VA 20176
- Reassigned Medicare billing, Virginia enrollment
- 103 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 4
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 94602 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.
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.
OAKLAND, CA 94602
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 Kasebaoth Mekonnen's NPI number?
The NPI number for Kasebaoth Mekonnen is 1467847855. It was assigned to this individual provider in the NPPES registry on April 1, 2015.
Where is Kasebaoth Mekonnen located?
Kasebaoth Mekonnen practices at 1411 E 31st St Emergency Department Ahs Highland Campus/Qic 22123, Oakland, CA 94602. The listed phone number is (510) 437-8356.
What is Kasebaoth Mekonnen's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is Kasebaoth Mekonnen enrolled in Medicare?
Yes. Kasebaoth Mekonnen is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Kasebaoth Mekonnen's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kasebaoth Mekonnen reassigns Medicare benefits to Commonwealth Emergency Physicians PC (Leesburg, VA). The 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 Kasebaoth Mekonnen'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 Kasebaoth Mekonnen was last updated on July 8, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Kasebaoth Mekonnen · NPI 1467847855
Emergency Medicine physician in Oakland, California. Individual provider, active in the CMS NPPES registry since April 1, 2015.
## Identity
- **NPI:** 1467847855 (Entity type: Individual)
- **Enumerated:** April 1, 2015
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** D87772 (Maryland)
- **Sole proprietor:** No
## Practice location
- **Address:** 1411 E 31ST ST, EMERGENCY DEPARTMENT AHS HIGHLAND CAMPUS/QIC 22123, Oakland, CA 94602-1018
- **Phone:** (510) 437-8356
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Commonwealth Emergency Physicians PC (NPI 1598723082, Leesburg, VA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 8, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1467847855) · Data from the CMS NPPES public registry.