Abraham Ybrah Mengstu

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

4351048513 Issued in MI

Practice address

16001 W 9 Mile Rd
Southfield, MI 48075-4818

Phone

(248) 849-2203

Fax

(248) 849-5395

NPI assigned

May 20, 2021

Last updated

May 23, 2021By 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 2

Addresses

Other names 1

• Abraha Ybrah Mengstu Other name

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1621468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621728000000",
    "number": "1174198444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16001 W 9 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754818",
            "telephone_number": "248-849-2203",
            "fax_number": "248-849-5395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16001 W 9 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754818",
            "telephone_number": "248-849-2203",
            "fax_number": "248-849-5395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENGSTU",
        "first_name": "ABRAHAM",
        "middle_name": "YBRAH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-20",
        "last_updated": "2021-05-23",
        "certification_date": "2021-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4351048513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABRAHA",
            "last_name": "MENGSTU",
            "middle_name": "YBRAH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kanwar Virender Mendiratta, M.D.
• Madhu Mendiratta, MD
• Surinder Mendiratta, MD
• Nayelie Mendoza
• Sergio Mendoza, MD
• Amanda Lyn Meninno, ATC, DPT
• Mentor for Health LLC
• Christopher Edward Meny, R.PH.
• Mer Home Healthcare Service LLC
• Abigail Merchant

• Diagnostic Radiology Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Diagnostic Radiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.