NPIMap

Individual provider Active NPI

Bethlehem Dessalegn Mekonnen, MD

  • Cornea and External Diseases Specialist Physician
  • Stanford, CA
National Provider Identifier
1306208087
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cornea and External Diseases Specialist PhysicianTaxonomy code 207WX0120X
License
A155258 Issued in CA
Practice address
300 Pasteur Dr
Stanford, CA 94305-2200
Phone
(650) 723-4000
NPI assigned
Mar 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A155258 CA
Cornea and External Diseases Specialist Physician 207WX0120X A155258 CA Primary

Addresses

Primary practice location

300 Pasteur Dr
Stanford, CA 94305-2200

Mailing address

513 Parnassus Ave
UCSF- Department of Surgery S-321
San Francisco, CA 94143-2205
Phone (919) 665-9984

Other practice location 1

513 Parnassus Ave
UCSF- Department of Surgery S-321
San Francisco, CA 94143-2205
Phone (919) 665-9984

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200622001268 CA Practitioner - OphthalmologyPractitioner - Other (Physician) 8628490653 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Yale University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Stanford Health CareGroup PAC ID 6709797491, 3,152 clinicians

Practice addresses (Care Compare)

1133 E Stanley Blvd
Suite 111
Livermore, CA 94550-4243
Phone (650) 723-4000

2452 Watson CT
Palo Alto, CA 94303-3216
Phone (650) 723-6995

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

5555 W Las Positas Blvd
Pleasanton, CA 94588-4000
Phone (925) 847-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.53 of 100Reported as group
Quality
87.08
Promoting interoperability
100
Improvement activities
40
Cost
69.51

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery156

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A155258CAMDCornea and External Diseases Specialist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stanford Health Care CurrentSince Jun 17, 2020 Accepting new patients
LPCH Medical Group Div of Lucile CurrentSince Jun 17, 2020 Accepting new patients
Stanford Health Care Current Accepting new patients
Stanford Health Care CurrentSince Jun 17, 2020 Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients
Lucile Salter Packard Children's Hospital at Stanford Past Accepting new patients

Locations

911 Sunset Dr
Hollister, CA 95023
Phone (831) 626-2640

1133 E Stanley Blvd
Ste 117
Livermore, CA 94550
Phone (925) 371-8885

1133 E Stanley Blvd
Ste 209
Livermore, CA 94550
Phone (925) 460-8167

7999 Gateway Blvd
Ste 200
Newark, CA 94560
Phone (510) 806-2947

725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979

2452 Watson Ct
Palo Alto, CA 94303
Phone (650) 721-6888

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

Interoperability endpoints

  • Direct secure messaging: bmekonnen271776@direct.stanfordhealthcare.org

Organizations & group practices 6

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1306208087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 PARNASSUS AVE",
            "address_2": "UCSF- DEPARTMENT OF SURGERY S-321",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432205",
            "telephone_number": "919-665-9984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "513 Parnassus Ave",
            "address_2": "UCSF- Department of Surgery S-321",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941432205",
            "country_code": "US",
            "telephone_number": "919-665-9984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEKONNEN",
        "first_name": "BETHLEHEM",
        "middle_name": "DESSALEGN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-22",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A155258",
            "primary": false
        },
        {
            "code": "207WX0120X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Cornea and External Diseases Specialist",
            "state": "CA",
            "license": "A155258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanford, CA

Sources for this page

Verify at the official NPI Registry.