KIDANU BIRHANU M.D.
NPI 1710073952
Internal Medicine in Dyer, IN
NPI Status: Active since October 05, 2006
Contact Information
24 JOLIET ST
STE 302
DYER, IN
ZIP 46311
Phone: (219) 852-2518
Fax: (219) 864-2156
- Individual
- Male
- Years of Experience 46
- Internal Medicine
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About KIDANU BIRHANU
This page provides the complete NPI Profile along with additional information for Kidanu Birhanu, an internist established in Dyer, Indiana with a medical specialization in Internal Medicine and more than 46 years of experience. The healthcare provider is registered in the NPI registry with number 1710073952 assigned on October 2006. The practitioner's primary taxonomy code is 207R00000X with license number 01066132 (IN). The provider is registered as an individual and his NPI record was last updated 10 years ago.
- NPI
- 1710073952
- Provider Name
- KIDANU BIRHANU M.D.
- Other Name
- KIDANU BIRHANU MD, PC
- Other Name Type
- Professional Name (2)
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 24 JOLIET ST STE 302 DYER, IN 46311
- Location Phone
- (219) 852-2518
- Location Fax
- (219) 864-2156
- Mailing Address
- 24 JOLIET ST STE 302 DYER, IN 46311
- Mailing Phone
- (219) 852-2518
- Mailing Fax
- (219) 864-2156
- Medical School Name
- OTHER
- Graduation Year
- 1980
- Is Sole Proprietor?
- No
- Enumeration Date
- 10-05-2006
- Last Update Date
- 03-30-2016
- Code Navigator
An internist like Kidanu Birhanu is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 01066132
- License State
- IN
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | 036072060 (IL) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 036072060 | MEDICAID (05) | IL | |
| M10029340 | MEDICARE PIN (08) | IN | |
| 205043 | MEDICARE ID-TYPE UNSPECIFIED (04) | IL | |
| 110248456 | OTHER (01) | IL | MEDICARE RAILROAD |
| E47873 | MEDICARE UPIN (02) | IL | |
| K45570 | MEDICARE PIN (08) | IL | |
| 01633358 | OTHER (01) | IL | BCBS OF IL |
Medicare Participation & PECOS Enrollment Status
Kidanu Birhanu is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Kidanu Birhanu is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 143317685
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20071031000477
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 45 times for 25 patientsThis 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.
This service was performed 48 times for 32 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $30.62 for a new patient copayment and $23.55 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 46311 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $122.49
- Minimum New Patient Price $53.07
- Maximum New Patient Price $161.76
- Average New Patient Copayment $30.62
- Minimum New Patient Copayment $13.26
- Maximum New Patient Copayment $40.44
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $94.22
- Minimum Established Patient Price $16.93
- Maximum Established Patient Price $132.22
- Average Established Patient Copayment $23.55
- Minimum Established Patient Copayment $4.23
- Maximum Established Patient Copayment $33.05
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Chronic Care and Preventative Care Management for Empaneled Patients | Yes | N/A |
| Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation. | ||
| Documentation of Current Medications in the Medical Record | 98% | 761 |
| 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. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| Engagement of patients through implementation of improvements in patient portal | Yes | N/A |
| Access to an enhanced patient portal that provides up to date information related to relevant chronic disease health or blood pressure control, and includes interactive features allowing patients to enter health information and/or enables bidirectional communication about medication changes and adherence. | ||
| e-Prescribing | 97% | 2737 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Implementation of improvements that contribute to more timely communication of test results | Yes | N/A |
| Timely communication of test results defined as timely identification of abnormal test results with timely follow-up. | ||
| Implementation of medication management practice improvements | Yes | N/A |
| Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews. | ||
| Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antiplatelet | 29% | 38 |
| 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 diagnosis of ischemic vascular disease (IVD) during the measurement period, and who had documentation of use of aspirin or another antiplatelet during the measurement period | ||
| Medication Reconciliation | 97% | 173 |
| 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. | ||
| Patient-Specific Education | 98% | 764 |
| 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. | ||
| Pneumococcal Vaccination Status for Older Adults | 9% | 166 |
| Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 12% | 762 |
| 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 twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2 | ||
| Provide Patient Access | 56% | 764 |
| 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 certain information. | ||
| Secure Messaging | 0% | 764 |
| 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 message sent by the patient (or the patient-authorized representative) during the performance period. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
| Specialized Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI. | ||
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Kidanu Birhanu is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| OSF LITTLE COMPANY OF MARY MEDICAL CENTER | 2800 W 95TH ST EVERGREEN PARK, IL 60805 | (708) 422-6200 | Acute Care Hospitals |
Reviews for KIDANU BIRHANU M.D.
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1710073952, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 58 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
DYER, IN 46311
DYER, IN 46311
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1710073952, enumerated as an "individual" on October 05, 2006.
The provider is located at 24 JOLIET ST STE 302 DYER, IN 46311 and the phone number is (219) 852-2518.
Internal Medicine with taxonomy code 207R00000X.
The provider might be accepting Accepts: Medicare, Medicaid, Railroad Medicare and Blue. Please consult your insurance carrier or call the provider to verify.
Kidanu Birhanu is affiliated with: OSF LITTLE COMPANY OF MARY MEDICAL CENTER.
