Individual provider Active NPI

Kibret Yohannes, MD

  • Surgery Physician
  • Boston, MA
National Provider Identifier
1215723432
Registry record updated Apr 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
3019506 Issued in MA
Practice address
330 Brookline Ave
Boston, MA 02215-5491
Phone
(617) 667-7000
NPI assigned
Apr 15, 2025
Last updated
Apr 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 3019506 MA Primary

Addresses

Primary practice location

330 Brookline Ave
Boston, MA 02215-5491

Mailing address

6320 Millwood CT
Springfield, VA 22152-2840
Phone (703) 585-6663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20250626002246 MA Order and Referring Only - General SurgeryPractitioner - General Surgery 4385156033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1744675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745712000000",
    "number": "1215723432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6320 MILLWOOD CT",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221522840",
            "telephone_number": "703-585-6663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155491",
            "telephone_number": "617-667-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOHANNES",
        "first_name": "KIBRET",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-15",
        "last_updated": "2025-04-27",
        "certification_date": "2025-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "3019506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.