Individual provider Active NPI

Wegahta Kidane Ghebreiyesus, MD

  • Internal Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1194619197
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4351054941 Issued in MI
Practice address
300 Lafayette Ave
Suite 3000
Grand Rapids, MI 49503
Phone
(616) 685-6919
Fax
(616) 685-3063
NPI assigned
Jun 4, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4351054941 MI Primary

Addresses

Primary practice location

300 Lafayette Ave
Suite 3000
Grand Rapids, MI 49503

Mailing address

200 Jefferson Ave
Suite 305
Grand Rapids, MI 49503
Phone (616) 685-4615

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4351054941MIMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: wghebreiyesus4421491@direct.trinity-health.org

NPI Registry JSON

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

{
    "created_epoch": "1748995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1194619197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 JEFFERSON AVE",
            "address_2": "SUITE 305",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49503",
            "telephone_number": "616-685-4615",
            "fax_number": "616-685-3033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LAFAYETTE AVE",
            "address_2": "SUITE 3000",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49503",
            "telephone_number": "616-685-6919",
            "fax_number": "616-685-3063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHEBREIYESUS",
        "first_name": "WEGAHTA",
        "middle_name": "KIDANE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-04",
        "last_updated": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4351054941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.