Active NPI
Medhanie Kifle Kifle, PA-C
- Physician Assistant
- Newark, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA2017-0013
- Practice address
- 1320 W Main St
Newark, OH 43055 - Phone
- (740) 348-4137
- Fax
- (740) 348-4119
- NPI assigned
- May 9, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA2017-0013 | NM | Primary |
| Physician Assistant | 363A00000X | 003744 | OH |
Addresses
Primary practice location
1320 W Main St
Newark, OH 43055
Mailing address
PO Box 26666
Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 923-6770
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1100 Central Ave SE
Albuquerque, NM 87106-4930
Phone (505) 841-1234
2200 W 21St St
Clovis, NM 88101-2011
Phone (505) 769-7577
2400 Unser Blvd SE
Rio Rancho, NM 87124-3392
2400 Unser Blvd SE
Rio Rancho, NM 87124-4740
8300 Constitution Ave NE
Albuquerque, NM 87110-7613
Hospital & facility affiliations
- Presbyterian Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.68 of 100
- Quality
- 82.35
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.6
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003744 | OH | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Presbyterian Healthcare Services | Current | Accepting new patients | |
| Presbyterian Healthcare Services | Current | Accepting new patients | |
| Presbyterian Healthcare Services | Past | Accepting new patients | |
| Licking Memorial Professional Corp. | Past | Accepting new patients |
Locations
3436 Isleta Blvd SW
Albuquerque, NM 87105
Phone (505) 462-7777
8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200
1100 Lead Ave SE
Albuquerque, NM 87106
Phone (505) 224-7000
2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577
2400 Unser Blvd SE
Ste 19100
Rio Rancho, NM 87124
Phone (505) 224-7000
2400 Unser Blvd SE
Ste 19100A
Rio Rancho, NM 87124
Phone (505) 224-7000
2400 Unser Blvd SE
Rio Rancho, NM 87124
Phone (505) 253-0000
4801 Beckner Rd
Santa Fe, NM 87507
Phone (505) 772-1234
Interoperability endpoints
- mkifle107763@direct.phs.org
Organizations & group practices 4
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.
-
- Internal Medicine Physician
- Albuquerque, NM
- NPI 1104802354
-
- General Acute Care Hospital
- Albuquerque, NM
- NPI 1215913470
-
- Pediatrics Physician
- Utica, OH
- NPI 1497771521
-
- Rural Acute Care Hospital
- Espanola, NM
- NPI 1154307593
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Albuquerque, NM
- NPI 1215913470
-
- Psychiatric Hospital Unit
- Albuquerque, NM
- NPI 1598740482
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1368057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550707200000",
"number": "1346685807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 26666",
"address_2": "PROVIDER ENROLLMENT",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871256666",
"telephone_number": "505-923-6770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1320 W MAIN ST",
"city": "NEWARK",
"state": "OH",
"postal_code": "43055",
"telephone_number": "740-348-4137",
"fax_number": "740-348-4119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIFLE",
"first_name": "MEDHANIE",
"middle_name": "KIFLE",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-05-09",
"last_updated": "2019-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NM",
"license": "PA2017-0013",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": "003744",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Newark, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2019; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.