Individual provider Active NPI

Berhanemeskel Nesketa, M.D.

  • Pulmonary Disease Physician
  • Owensboro, KY
National Provider Identifier
1003126996
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
47275 Issued in KY
Practice address
1301 Pleasant Valley Rd
Suite 404
Owensboro, KY 42303-9774
Phone
(270) 417-7500
Fax
(270) 417-7699
NPI assigned
Oct 13, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pulmonary Disease Physician 207RP1001X 47275 KY Primary

Addresses

Primary practice location

1301 Pleasant Valley Rd
Suite 404
Owensboro, KY 42303-9774

Mailing address

PO Box 23229
Owensboro, KY 42304-3229
Phone (270) 688-1330

Other identifiers 2

IdentifierTypeStateIssuer
7100304030MedicaidKY
201249550MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bnesketa48062@direct.owensborohealth.org Owensboro Health Medical Group, Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140902001763 KY Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 3173741220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1201 Pleasant Valley Rd
Owensboro, KY 42303-9811

1301 Pleasant Valley Rd
Owensboro, KY 42303-9774

2211 Mayfair Dr
Owensboro, KY 42301-4569

PO Box
Suite 23229
Owensboro, KY 42304-3229

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Owensboro Health Medical Group Inc Current Accepting new patients
Owensboro Health Medical Group Inc CurrentSince Sep 1, 2014 Accepting new patients
Owensboro Health Medical Group Inc CurrentSince Sep 1, 2014 Accepting new patients
Owensboro Health Medical Group, Inc Family Medicine Past Accepting new patients

Locations

2211 Mayfair Dr
Ste 101
Owensboro, KY 42301
Phone (270) 688-1352

2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351

1301 Pleasant Valley Rd
Ste 404
Owensboro, KY 42303
Phone (270) 417-7500

Interoperability endpoints

  • Direct secure messaging: bnesketa48062@direct.owensborohealth.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1286928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1003126996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23229",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423043229",
            "telephone_number": "270-688-1330",
            "fax_number": "270-688-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PLEASANT VALLEY RD",
            "address_2": "SUITE 404",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423039774",
            "telephone_number": "270-417-7500",
            "fax_number": "270-417-7699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NESKETA",
        "first_name": "BERHANEMESKEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-13",
        "last_updated": "2023-11-27",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "KY",
            "license": "47275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100304030",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201249550",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bnesketa48062@direct.owensborohealth.org",
            "affiliation": "Y",
            "affiliationName": "Owensboro Health Medical Group, Inc",
            "address_1": "1301 Pleasant Valley Rd Ste 404",
            "city": "Owensboro",
            "state": "KY",
            "country_code": "US",
            "postal_code": "423039774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

Verify at the official NPI Registry.