Kifle Admassu MD PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

M1448 Issued in TX

Legal business name

KIFLE ADMASSU MD PA

Practice address

305 Hawks Ridge TRL
Colleyville, TX 76034-8213

Phone

(817) 960-6648

Fax

(817) 960-6649

NPI assigned

May 10, 2007

Organization subpart

No

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

Authorized official

Name

Kifle Admassu, MDNPI 1184664401

Title

President and Ceo

Phone

(817) 960-6648

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kifle Admassu, MD

  • Internal Medicine Physician
  • Azle, TX
  • NPI 1184664401
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435276800000",
    "number": "1083829527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 HAWKS RIDGE TRL",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "760348213",
            "telephone_number": "817-960-6648",
            "fax_number": "817-960-6649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 HAWKS RIDGE TRL",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "760348213",
            "telephone_number": "817-960-6648",
            "fax_number": "817-960-6649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIFLE ADMASSU MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2015-06-26",
        "status": "A",
        "authorized_official_last_name": "ADMASSU",
        "authorized_official_first_name": "KIFLE",
        "authorized_official_title_or_position": "PRESIDENT AND  CEO",
        "authorized_official_telephone_number": "817-960-6648",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M1448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "M1448",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW MEDICARE NUMBER",
            "identifier": "00X656",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER MEDICARE #",
            "identifier": "612406",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Ann Kerich, PA
• Riad Kesiry, MD
• Arras Darius Khaledi
• Rehan A. Khan, MD
• Zahira Khimji, OTR/L
• David D Kim, M.D.
• Hyung S Kim, DMD
• Kinesio Kids, LLC
• Christopher King, DDS
• Tamra Renee King, MS,LPC ASSOCIATE

• Internal Medicine Physician in Colleyville, TX
• Providers in Colleyville, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.