Individual provider Active NPI

Fikre A. Mengistu, M.D.

  • Surgery Physician
  • Henderson, NV
National Provider Identifier
1073812640
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
16567 Issued in NV
Practice address
10001 S Eastern Ave Ste 201
Henderson, NV 89052
Phone
(702) 914-2420
Fax
(702) 914-6653
NPI assigned
Mar 22, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 16567 NV Primary

Addresses

Primary practice location

10001 S Eastern Ave Ste 201
Henderson, NV 89052

Mailing address

10001 S Eastern Ave Ste 310
Henderson, NV 89052-3908
Phone (702) 914-2420

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20160802002494 NV Practitioner - General Surgery 4587883012 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Howard University College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Nevada Surgery Specialists LTDGroup PAC ID 9537146063, 15 clinicians

Practice addresses (Care Compare)

10001 S Eastern Ave
Suite 310
Henderson, NV 89052-3908
Phone (702) 914-2420

Hospital & facility affiliations

  • Saint Rose Dominican Hospitals - Siena Campus Hospital, Henderson, NV, CCN 290045
  • West Henderson Hospital Hospital, Henderson, NV, CCN 290062
  • Saint Rose Dominican Hospitals - Rose de Lima Hospital, Henderson, NV, CCN 290012
  • Saint Rose Dominican Hospitals - San Martin Campus Hospital, Las Vegas, NV, CCN 290053

Merit-based Incentive Payment System (MIPS)

Final score
87.18 of 100Reported as group
Quality
80.29
Promoting interoperability
100
Improvement activities
40
Cost
69.68

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16567NVMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Nevada Surgery Specialists LTD Surgery CurrentSince Jul 1, 2016 Accepting new patients

Locations

10001 S Eastern Ave
Ste 201
Henderson, NV 89052
Phone (702) 914-2420

10001 S Eastern Ave
Ste 310
Henderson, NV 89052
Phone (702) 566-2400

2410 Fire Mesa St
Ste 170
Las Vegas, NV 89128
Phone (702) 483-4483

8285 W Arby Ave
Ste 225
Las Vegas, NV 89113
Phone (702) 236-4181

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5551/brand/1/csg/1/fhir/r4
  • Direct secure messaging: fikre.mengistu.1@5551.direct.athenahealth.com

Organizations & group practices 1

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": "1300752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1073812640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10001 S EASTERN AVE STE 310",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523908",
            "telephone_number": "702-914-2420",
            "fax_number": "702-914-6653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10001 S EASTERN AVE STE 201",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "89052",
            "telephone_number": "702-914-2420",
            "fax_number": "702-914-6653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENGISTU",
        "first_name": "FIKRE",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-22",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NV",
            "license": "16567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.