Individual provider Active NPI

Fekade Tefera, M.D.

  • Nephrology Physician
  • Brooklyn, NY
National Provider Identifier
1336177328
Registry record updated Oct 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
224113 Issued in NY
Practice address
1222 E 96TH St
Brooklyn, NY 11236-3903
Phone
(718) 874-7095
Fax
(718) 233-3464
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 224113 NY Primary

Addresses

Primary practice location

1222 E 96TH St
Brooklyn, NY 11236-3903

Mailing address

148 Crescent Ave
East Brunswick, NJ 08816-5416
Phone (732) 251-2048

Other identifiers 1

IdentifierTypeStateIssuer
01702978MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20041014000482 NY Practitioner - NephrologyPractitioner - Internal Medicine 9335109370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1555 Rockaway Pkwy
Suite 4
Brooklyn, NY 11236-4001
Phone (718) 927-6300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
224113NYMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kidney Care Associates, PLLC Nephrology CurrentSince Jul 1, 2006 Accepting new patients
The Brookdale Hospital Medical Center Past Accepting new patients
Brookdale Family Care Center, Inc. Past Accepting new patients
Sheepshead Bay Medical Associates, PC PastSince Apr 1, 2004 Accepting new patients
Brookdale Hospital Medical Center Past Accepting new patients

Locations

9701 Church Ave
Rm 101
Brooklyn, NY 11212
Phone (718) 240-5615

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

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 1

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380758400000",
    "number": "1336177328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 CRESCENT AVE",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088165416",
            "telephone_number": "732-251-2048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 E 96TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112363903",
            "telephone_number": "718-874-7095",
            "fax_number": "718-233-3464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEFERA",
        "first_name": "FEKADE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2013-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "224113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01702978",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.