Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. ABYOT DEREJE MD
NPI 1689475766
Student in an Organized Health Care Education/Training Program in Tupelo, MS

Q: What is Abyot Dereje's NPI number?

The NPI number for Abyot Dereje is 1689475766. It was assigned to this individual provider in the NPPES registry on March 24, 2025.

Q: What is Abyot Dereje's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Abyot Dereje was last updated on June 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 57 days 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 March 24, 2025PECOS Enrolled

1665 S GREEN ST, TUPELO, MS 38804(786) 315-5925 Get Directions Write a Review

NPPES record last updated: June 17, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Abyot Dereje Md NPPES

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

DR. ABYOT DEREJE MD (NPI 1689475766) is an individual student in an organized health care education/training program in Tupelo, Mississippi and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS and maintains a secondary practice location in Miami.

NPPES Registry Identity

NPI1689475766

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameDR. ABYOT DEREJECredential: MD

Location Address1665 S GREEN STTupelo, MS 38804-6556

Mailing Address1665 S Green StTupelo, MS 38804-6556 · (786) 315-5925

Phone(786) 315-5925

Sole ProprietorNo

Enumeration DateMarch 24, 2025

Last NPPES UpdateJune 17, 2026

NPPES CertifiedJune 17, 2026

✔ NPI 1689475766 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

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.

1665 S GREEN ST, Tupelo, MS 38804

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Secondary Practice Location 1

Location 111880 SW 40th St Ste 416Miami, FL 33175-3575 · Phone (786) 315-5925

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Abyot Dereje Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

YONG SEOK CHANG DO

Student in an Organized Health Care Education/Training Program