Edom Kidane, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

67091 Issued in WI

Practice address

3237 S 16TH St
Milwaukee, WI 53215

Phone

(414) 389-4845

NPI assigned

Jul 15, 2015

Last updated

Aug 22, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

HospitalistAlso: Internal Medicine

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ascension Medical Group-Southeast Wisconsin IncGroup PAC ID 8628980943, 551 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension SE Wisconsin Hospital Hospital, Milwaukee, WI, CCN 520136
• St Josephs Hospital Inpatient rehabilitation facility, Milwaukee, WI, CCN 52T136

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ascension Medical Group-Southeast Wisconsin Inc

  dba Ascension Medical Group

  • Internal Medicine Physician
  • Glendale, WI
  • NPI 1609881077
  Medicare reassignment Care Compare group NPD

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

• Ascension SE Wisconsin Hospital, Inc

  dba Ascension SE Wisconsin Hospital-Elmbrook Campus

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1427007384
  Care Compare affiliation
• Ascension SE Wisconsin Hospital, Inc

  dba Ascension SE Wisconsin Hospital-Elmbrook Campus

  • Rehabilitation Hospital Unit
  • Brookfield, WI
  • NPI 1861417362
  Care Compare affiliation

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

{
    "created_epoch": "1436918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1366826760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3237 S 16TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154526",
            "telephone_number": "414-389-4845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3237 S 16TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53215",
            "telephone_number": "414-389-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDANE",
        "first_name": "EDOM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-15",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WI",
            "license": "67091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robyn Kibler, RDH
• Kilah M Kichura, PAC
• Colleen Kickbush
• Jennifer Susan Kickendahl, MD
• Srividya Kidambi, M.D.
• Britney Kidd
• Charles F Kidd, MD
• Kidney Institute of Wisconsin, LLC
• Kids College Corporation
• Kids in Balance

• Hospitalist Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Hospitalist Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; 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.

Verify at the official NPI Registry.