ADISU TESFAY KIROS
NPI 1720848427
Student in an Organized Health Care Education/Training Program in Fresno, CA

Q: What is the provider's specialty?

The provider's specialty is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since March 20, 2024PECOS Enrolled

4711 W ASHLAN AVE, FRESNO, CA 93722(559) 203-6640 Get Directions Write a Review

NPPES record last updated: March 20, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Adisu Tesfay Kiros NPPES

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

ADISU TESFAY KIROS (NPI 1720848427) is an individual student in an organized health care education/training program in Fresno, California and active in the NPI registry since March 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1720848427

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameADISU TESFAY KIROS

Location Address4711 W ASHLAN AVEFresno, CA 93722-4307

Mailing AddressPo Box 737San Joaquin, CA 93660-0737 · (559) 203-6640

Phone(559) 203-6640

Sole ProprietorYes

Enumeration DateMarch 20, 2024

NPPES CertifiedMarch 20, 2024

✔ NPI 1720848427 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.

4711 W ASHLAN AVE, Fresno, CA 93722

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Adisu Tesfay Kiros 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.