Individual provider Active NPI

Dawit Wubishet, MD

  • Internal Medicine Physician
  • Far Rockaway, NY
National Provider Identifier
1083971311
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35099224 Issued in OH
Practice address
327 Beach 19TH St
Far Rockaway, NY 11691-4423
Phone
(718) 869-7000
NPI assigned
Apr 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 112222 NY
Internal Medicine Physician 207R00000X 35099224 OH Primary

Addresses

Primary practice location

327 Beach 19TH St
Far Rockaway, NY 11691-4423

Mailing address

2004 Seagirt Blvd
5G
Far Rockaway, NY 11691-2802
Phone (240) 421-7554

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dwubishet24111@lickingmemorial.medicity.net Licking Memorial Health Professionals

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20120823000331 OH Practitioner - HospitalistPractitioner - Internal Medicine 5395992523 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Licking Memorial Health ProfessionalsGroup PAC ID 6204740731, 235 clinicians

Practice addresses (Care Compare)

1320 W Main St
Newark, OH 43055-1822
Phone (220) 564-4137

181 Taylor Ave
Columbus, OH 43203-1779
Phone (614) 257-2358

272 Hospital Rd
Chillicothe, OH 45601-9031
Phone (740) 779-7500

6001 E Broad St
Columbus, OH 43213-1502
Phone (614) 234-6000

Hospital & facility affiliations

  • Adena Regional Medical Center Hospital, Chillicothe, OH, CCN 360159
  • Licking Memorial Hospital Hospital, Newark, OH, CCN 360218
  • Adena Fayette Medical Center Hospital, Washington CH, OH, CCN 361331
  • Adena Pike Medical Center Hospital, Waverly, OH, CCN 361334

Merit-based Incentive Payment System (MIPS)

Final score
89.83 of 100Reported as group
Quality
78.11
Improvement activities
40
Cost
74.76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
112222NYMDSocial Worker
35099224OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Ohio-Columbus II Professional Corp Internal Medicine CurrentSince May 22, 2025 Accepting new patients
Adena Health System Past Accepting new patients
Licking Memorial Hospital Past Accepting new patients

Locations

272 Hospital Rd
Chillicothe, OH 45601
Phone (740) 779-4275

181 Taylor Ave
Columbus, OH 43203
Phone (614) 257-2358

550 Mirabeau St
Greenfield, OH 45123
Phone (937) 672-4128

100 Dawn Ln
Waverly, OH 45690
Phone (740) 947-2186

Interoperability endpoints

  • Direct secure messaging: dwubishet2895218@direct.trinity-health.org
  • Direct secure messaging: jnr4655y@yourcarecommunity.org

Organizations & group practices 6

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": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1083971311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2004 SEAGIRT BLVD",
            "address_2": "5G",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116912802",
            "telephone_number": "240-421-7554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 BEACH 19TH ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116914423",
            "telephone_number": "718-869-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUBISHET",
        "first_name": "DAWIT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-11",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "112222",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35099224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dwubishet24111@lickingmemorial.medicity.net",
            "affiliation": "Y",
            "affiliationName": "Licking Memorial Health Professionals",
            "address_1": "1320 W Main St",
            "city": "Newark",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430551822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

Verify at the official NPI Registry.