Berhanu Ejigu Kededa, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN152429 Issued in GA

Practice address

5576 Princeton Run TRL
Tucker, GA 30084-8463

Phone

(678) 793-8808

NPI assigned

Jan 6, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Berhanu Kedida Ejigu Former name

Medicare fee-for-service enrollment

Enrolled in GA, OR2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Post Acute Medical PLLCGroup PAC ID 5193156115, 433 clinicians

Daiya Healthcare PLLCGroup PAC ID 6002158615, 80 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fairlawn Health and Rehabilitation of Cascadia Nursing home, Gresham, OR, CCN 385133

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: berhanu.kededa@hca1.eclinicaldirectplus.com

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.

• Matthew'S Family Primary Care, LLC

  • Family Medicine Physician
  • Milwaukie, OR
  • NPI 1629899448

  Multi-Specialty

  Medicare reassignment NPD Authorized official
• Post Acute Medical PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Lanham, MD
  • NPI 1730713025

  Multi-Specialty, OR

  Medicare reassignment Care Compare group NPD
• Daiya Healthcare PLLC

  • Internal Medicine Physician
  • Bellevue, WA
  • NPI 1477027381

  OR

  Medicare reassignment Care Compare group
• Cep America LLC

  • Emergency Medicine Physician
  • Lithonia, GA
  • NPI 1124073721

  Multi-Specialty

  Medicare reassignment NPD
• Gwinnett Physician Group, LLC

  • Internal Medicine Physician
  • Lawrenceville, GA
  • NPI 1578574661

  Multi-Specialty

  Medicare reassignment NPD
• Impact Physician Group, LLC

  • Internal Medicine Physician
  • Peachtree City, GA
  • NPI 1114428612

  Multi-Specialty, OR

  Medicare reassignment NPD
• Altea Medical Oregon LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Portland, OR
  • NPI 1184451254

  Multi-Specialty

  Medicare reassignment NPD
• B & B Residential Care Services, LLC

  • Registered Nurse
  • Milwaukie, OR
  • NPI 1780427278
  NPD Authorized official
• Gwinnett Heart Specialists LLC

  • Cardiovascular Disease Physician
  • Lawrenceville, GA
  • NPI 1679818991

  Multi-Specialty

  NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946

  Multi-Specialty

  NPD
• Gwinnett Medical Group, Inc

  • General Practice Physician
  • Lawrenceville, GA
  • NPI 1780747469

  Multi-Specialty

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Gresham of Cascadia, LLC

  • Skilled Nursing Facility
  • Gresham, OR
  • NPI 1417667262

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1325808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1184994105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5576 PRINCETON RUN TRL",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300848463",
            "telephone_number": "678-793-8808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5576 PRINCETON RUN TRL",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300848463",
            "telephone_number": "678-793-8808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEDEDA",
        "first_name": "BERHANU",
        "middle_name": "EJIGU",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-06",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Home Health",
            "state": "OR",
            "license": "202205124RN",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN152429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BERHANU",
            "last_name": "EJIGU",
            "middle_name": "KEDIDA",
            "credential": "NP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Janeth Kamenge, NP
• Jennifer Gall Kapella, MD
• Saba Karamali
• Danielle Alyssa Kardon, MOT, OTR/L
• Glenn Kasow, DO
• Keeping U Gorgeous Extensions &Wigs LLC
• Shannon A Keller
• Kelly Keyser, LLC
• Caleb Elijah Keran, DC
• Jane M Kerner-Mendoza, CNS

• Family Nurse Practitioner in Tucker, GA
• Providers in Tucker, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2025; 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.