FITSUMBERHAN GIRMA MEDHANE
NPI 1740643154
Student in an Organized Health Care Education/Training Program in Bronx, NY

NPI Status: Active since April 02, 2016

Contact Information

1400 PELHAM PKWY S
BRONX, NY
ZIP 10461
Phone: (718) 918-5640
Fax: (718) 918-3174

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  • Individual
  • Male
  • Years of Experience 16
  • Student in an Organized Health Care Educ...
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About FITSUMBERHAN MEDHANE

This page provides the complete NPI Profile along with additional information for Fitsumberhan Medhane, a primary care provider established in Bronx, New York with a medical specialization in Student In An Organized Health Care Education/training Program and more than 16 years of experience. The healthcare provider is registered in the NPI registry with number 1740643154 assigned on April 2016. The practitioner's primary taxonomy code is 390200000X. The provider is registered as an individual and his NPI record was last updated 10 years ago.

NPI
1740643154
Provider Name
FITSUMBERHAN GIRMA MEDHANE
Gender
Male
Entity Type
Individual
Location Address
1400 PELHAM PKWY S BRONX, NY 10461
Location Phone
(718) 918-5640
Location Fax
(718) 918-3174
Mailing Address
4921 SEMINARY RD APT 712 ALEXANDRIA, VA 22311
Mailing Phone
(571) 458-9226
Medical School Name
OTHER
Graduation Year
2010
Is Sole Proprietor?
No
Enumeration Date
04-02-2016
Last Update Date
04-02-2016
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A primary care provider (PCP) like Fitsumberhan Medhane sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, 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

Student in an Organized Health Care Education/Training Program

Taxonomy Code
390200000X
Type
Student, Health Care
Taxonomy Description
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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Premera Blue Cross Alaska One Gold - PPO
  • Premera Blue Cross Preferred Bronze 5800 HSA - PPO
  • Premera Blue Cross Preferred Bronze 6350 - PPO
  • Premera Blue Cross Preferred Gold 1500 - PPO
  • Premera Blue Cross Preferred Silver 4500 - PPO
  • Premera Blue Cross Standard Bronze II - PPO
  • Premera Blue Cross Standard Gold - PPO
  • Premera Blue Cross Standard Silver - PPO
  • Premera Blue Cross Family Dental - PPO
  • Premera Blue Cross Pediatric Dental - PPO
  • HSA-E Qualified 7500 Bronze - Signature Network - EPO
  • Providence Oregon Standard Bronze Plan - Signature Network - EPO
  • Providence Oregon Standard Gold Plan - Signature Network - EPO
  • Providence Oregon Standard Silver Plan - Signature Network - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Fitsumberhan Medhane 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.

Fitsumberhan Medhane 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: 345622379

    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: I20220808000335

    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.

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician

An exercise or drug-induced heart stress test with ECG involves monitoring your heart's activity while it's under stress, either from exercise or medication. A doctor supervises the entire procedure to ensure safety and accuracy in results. This test helps detect heart problems.

This service was performed 16 times for 16 patients

New patient office or other outpatient visit, 60-74 minutes

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

This service was performed 17 times for 17 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

This service was performed 106 times for 100 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

This service was performed 44 times for 43 patients

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. Fitsumberhan Medhane is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
EVERGREENHEALTH MONROE14701 179TH AVE SE
MONROE, WA 98272
(360) 794-7497Acute Care Hospitals
EVERGREENHEALTH MEDICAL CENTER12040 NE 128TH STREET
KIRKLAND, WA 98034
(425) 899-1000Acute Care Hospitals

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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 1740643154, we treat the final digit (4) 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 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).

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.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
4
Doubled → 8
Pos 4
0
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
4
Unchanged
Pos 7
3
Doubled → 6
Pos 8
1
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
4
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 4 → 8 6 → 12 → 3 3 → 6 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 8 + 0 + 1 + 2 + 4 + 6 + 1 + 1 + 0 + 24 = 56

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 56 is 60. The difference is the calculated check digit.

60 - 56 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1740643154.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Genetic Counselor, MS
1400 PELHAM PKWY S, BUILDING 1, ROOM 1N43H
BRONX, NY 10461
General Practice
1400 PELHAM PKWY S, JACOBI MEDICAL CENTER 1E12
BRONX, NY 10461
Dentist
1400 PELHAM PKWY S, JACOBI MEDICAL CENTER
BRONX, NY 10461
Internal Medicine (Gastroenterology)
1400 PELHAM PKWY S
BRONX, NY 10461
Internal Medicine
1400 PELHAM PKWY S
BRONX, NY 10461
Dentist (Pediatric Dentistry)
1400 PELHAM PKWY S
BRONX, NY 10461
Internal Medicine
1400 PELHAM PKWY S
BRONX, NY 10461
Psychiatry & Neurology (Psychiatry)
1400 PELHAM PKWY S, JACOBI MEDICAL CENTER
BRONX, NY 10461
Nurse Practitioner (Obstetrics & Gynecology)
1400 PELHAM PKWY S
BRONX, NY 10461
Obstetrics & Gynecology (Maternal & Fetal Medicine)
1400 PELHAM PKWY S
BRONX, NY 10461
Internal Medicine (Pulmonary Disease)
1400 PELHAM PKWY S, 5N-50
BRONX, NY 10461
Internal Medicine (Cardiovascular Disease)
1400 PELHAM PKWY S, BLDG 1 ROOM 5E-02
BRONX, NY 10461
Emergency Medicine (Pediatric Emergency Medicine)
1400 PELHAM PKWY S
BRONX, NY 10461
Internal Medicine
1400 PELHAM PKWY S
BRONX, NY 10461
Internal Medicine
1400 PELHAM PKWY S
BRONX, NY 10461
Internal Medicine
1400 PELHAM PKWY S
BRONX, NY 10461
Internal Medicine
1400 PELHAM PKWY S
BRONX, NY 10461
Internal Medicine
1400 PELHAM PKWY S
BRONX, NY 10461
Internal Medicine
1400 PELHAM PKWY S
BRONX, NY 10461
Internal Medicine
1400 PELHAM PKWY S
BRONX, NY 10461

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1740643154, enumerated as an "individual" on April 02, 2016.

The provider is located at 1400 PELHAM PKWY S BRONX, NY 10461 and the phone number is (718) 918-5640.

Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

The provider might be accepting Accepts: Premera Blue Cross Blue Shield of Alaska and. Please consult your insurance carrier or call the provider to verify.

Fitsumberhan Medhane is affiliated with: EVERGREENHEALTH MONROE and EVERGREENHEALTH MEDICAL CENTER.