Tewodros Fesseha, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

4301056254 Issued in MI

Practice address

22255 Greenfield Rd
Suite 240
Southfield, MI 48075-3710

Phone

(248) 552-8525

Fax

(248) 552-1134

NPI assigned

Mar 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ND

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

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Sanford Bismarck

  • Multi-Specialty Clinic/Center
  • Bismarck, ND
  • NPI 1811941172
  Medicare reassignment NPD
• St. Alexius Medical Center

  • Specialist
  • Bismarck, ND
  • NPI 1205868429
  Medicare reassignment NPD
• Sanford Bismarck

  • Occupational Medicine Clinic/Center
  • Dickinson, ND
  • NPI 1669524351
  NPD
• St Alexius Medical Center

  • Home Infusion Therapy Pharmacy
  • Bismarck, ND
  • NPI 1063663607
  NPD
• Urology Center PC

  • Durable Medical Equipment & Medical Supplies
  • Fremont, NE
  • NPI 1851126643

  Urology

  NPD (past)

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412208000000",
    "number": "1225098783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22255 GREENFIELD RD",
            "address_2": "SUITE 240",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753710",
            "telephone_number": "248-552-8525",
            "fax_number": "248-552-1134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22255 GREENFIELD RD",
            "address_2": "SUITE 240",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753710",
            "telephone_number": "248-552-8525",
            "fax_number": "248-552-1134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FESSEHA",
        "first_name": "TEWODROS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2014-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "4301056254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "34063119028",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "413271410",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tahmina Ferdous, PA
• Robert J Ference, M.D.
• Allison Ferman
• Jada Saleen Ferrell
• Howard Fertel, D.O.
• Richard D Fessler II, MD
• Haroun Fetteh, D.C.
• Elijah Fettig
• FFC PLLC
• Fhpim, PLC

• Urology Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Urology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; 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.