Tadesse Kebede Debele, MD, MS

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

26094 Issued in NV

Practice address

4900 W Craig Rd
Las Vegas, NV 89130-2737

Phone

(252) 693-3687

Fax

(725) 293-5350

NPI assigned

Nov 1, 2018

Last updated

Aug 16, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

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

Specialty

Family Practice

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Archwell Health Professional Services of Nevada PCGroup PAC ID 3779966999, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Archwell Health Professional Services of Nevada, P.C.

  • Internal Medicine Physician
  • Henderson, NV
  • NPI 1487303145
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1541030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1164999660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WOODMONT BLVD STE 600",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372055250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 W CRAIG RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891302737",
            "telephone_number": "252-693-3687",
            "fax_number": "725-293-5350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2202 N Stockton Hill Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Kingman",
            "state": "AZ",
            "postal_code": "864014622",
            "country_code": "US",
            "telephone_number": "702-877-5199",
            "fax_number": "702-431-0265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEBELE",
        "first_name": "TADESSE",
        "middle_name": "KEBEDE",
        "credential": "MD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-01",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA2058",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AZ",
            "license": "R78887",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "R7887",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "26094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164999660",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharnelle Jeannette Deayon
• Deb K Mukhopadhyay MD PC
• Glen Nelson Debarros
• Debbie Tilton Otrl Inc (Tiltons Therapy For Tots Inc)
• Debbie Tilton Otrl Inc (Tiltons Therapy For Tots)
• Arnold Debelen, MD
• Joseph A Debellis, MD
• Adryana Desiree Debenedittis, RBT
• Laura Debenham, QMHA
• Panisse Debesai

• Family Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Family Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.