Individual provider Active NPI

Eyuel Terefe, MD

  • Psychiatry Physician
  • Baldwin, WI
National Provider Identifier
1003341652
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
69219 Issued in AZ
Practice address
1100 Bergslien St
Baldwin, WI 54002-2600
Phone
(715) 684-1553
Fax
(715) 684-1119
NPI assigned
Apr 20, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 75173 WI
Student in an Organized Health Care Education/Training Program 390200000X BP10060999 TX
Psychiatry Physician 2084P0800X 69219 AZ Primary

Addresses

Primary practice location

1100 Bergslien St
Baldwin, WI 54002-2600

Mailing address

1100 Bergslien St
Baldwin, WI 54002-2600
Phone (715) 684-1553

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eterefe557802@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210701001188 WI Practitioner - Psychiatry 3779851043 Reassigns benefits to 1 organization
I20230602001215 AZ Practitioner - Psychiatry 3779851043 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Oklahoma College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yuma Regional Medical CenterGroup PAC ID 2062314826, 367 clinicians

Practice addresses (Care Compare)

7201 E 31St PL
Yuma, AZ 85365-8394
Phone (928) 336-5660

Hospital & facility affiliations

  • Yuma Regional Medical Center Hospital, Yuma, AZ, CCN 030013

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10060999TXMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Baldwin Area Medical Center Inc. CurrentSince Jul 1, 2021 Accepting new patients
Yuma Regional Medical Center CurrentSince Jun 24, 2023 Accepting new patients
Baldwin Area Medical Center, Inc. Current Accepting new patients
Baldwin Area Medical Center, Inc. CurrentSince Jul 1, 2021 Accepting new patients
Yuma Regional Medical Center Past Accepting new patients

Locations

2400 S Avenue A
Yuma, AZ 85364
Phone (928) 336-7100

7200 E 31st Pl
Yuma, AZ 85365
Phone (928) 336-2090

1100 Bergslien St
Baldwin, WI 54002
Phone (715) 684-1111

Networks

  • NM HMO C-SNP

Interoperability endpoints

  • Direct secure messaging: eterefe557802@excellian.direct.allina.com

Organizations & group practices 5

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 1

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": "1492646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1003341652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 BERGSLIEN ST",
            "city": "BALDWIN",
            "state": "WI",
            "postal_code": "540022600",
            "telephone_number": "715-684-1553",
            "fax_number": "715-684-1119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 BERGSLIEN ST",
            "city": "BALDWIN",
            "state": "WI",
            "postal_code": "540022600",
            "telephone_number": "715-684-1553",
            "fax_number": "715-684-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEREFE",
        "first_name": "EYUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-20",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "75173",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP10060999",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "69219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eterefe557802@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "1100 Bergslien St",
            "city": "Baldwin",
            "state": "WI",
            "country_code": "US",
            "postal_code": "540022600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baldwin, WI

Sources for this page

Verify at the official NPI Registry.