Individual provider Active NPI

Biniyam Beyene Tabor

  • Diagnostic Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1114868452
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MT235961 Issued in PA
Practice address
1025 Walnut St
Philadelphia, PA 19107-5001
Phone
(215) 955-6028
NPI assigned
Apr 2, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MT235961 PA Primary

Addresses

Primary practice location

1025 Walnut St
Philadelphia, PA 19107-5001

Mailing address

2209 Carpenter St Apt 1
Philadelphia, PA 19146-2565
Phone (445) 345-0167

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MT235961PAMDDiagnostic Radiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1775088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1114868452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 CARPENTER ST APT 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191462565",
            "telephone_number": "445-345-0167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 WALNUT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075001",
            "telephone_number": "215-955-6028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABOR",
        "first_name": "BINIYAM",
        "middle_name": "BEYENE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-04-02",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MT235961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.