Mesfin Etana Abdissa, MD
Individual provider Active NPI Internal Medicine Physician · Milwaukee, WI
NPI 1376579417 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1376579417
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 48957 (WI)
- Practice address
- 6901 W Edgerton Ave
Milwaukee, WI 53220-4420 - Phone
- (414) 423-5179
- NPI assigned
- Jun 23, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 14
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Fairview Health Services
Practice addresses (Care Compare)
420 Delaware St SE
Minneapolis, MN 55455-0341
Phone (612) 273-3000
Hospital & facility affiliations
- M Health Fairview Ridges Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 96.44 of 100
- Quality
- 82.65
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 77.21
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070919000305 | MN | Practitioner - Internal Medicine | 1456363829 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48957 | WI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview Clinics | Current |
Accepting new patients | |
| Fairview Express Care | Current | Accepting new patients | |
| Fairview Clinics | Current |
Accepting new patients | |
| Healtheast Medical Research Institute | Current | Accepting new patients | |
| Fairview Express Care | Current |
Accepting new patients | |
| Fairview Health Services | Current |
Accepting new patients | |
| Healtheast Medical Research Institute | Internal Medicine | Current |
Accepting new patients |
| Fairview Express Care | Current |
Accepting new patients | |
| Fairview Health Services | Current | Accepting new patients | |
| Healtheast Medical Research Institute | Current |
Accepting new patients | |
| Fairview Health Services | Past | Accepting new patients | |
| Allina Health System | Past | Accepting new patients | |
| United Hospital District Inc. | Past |
Accepting new patients |
Locations
201 E Nicollet Blvd
Burnsville, MN 55337
Phone (952) 892-2000
14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400
1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860
6545 France Ave S
Ste 586
Edina, MN 55435
Phone (952) 915-8770
420 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-6483
400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203
717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617
6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477
911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313
1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000
2155 Ford Pkwy
Ste A
Saint Paul, MN 55116
Phone (651) 696-5000
69 Exchange St W
Saint Paul, MN 55102
Phone (651) 232-1100
45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000
1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100
Interoperability endpoints
- mabdissa71546@fairview.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 48957 | WI | Yes |
Addresses
Primary practice location
6901 W Edgerton Ave
Milwaukee, WI 53220-4420
Mailing address
1000 Devonshire LN Apt A116
A116
Bloomington, MN 55431-5032
Phone (240) 893-7484
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34871300 | Medicaid | WI |
Other providers in Milwaukee, WI
- Abdullahi M Abdi
- Ahmed Abdi
- Mustaf Abdi
- Nasteho Mohamed Abdi
- Aminah Shanell Abdikadir
- Mohammad Abdul Azeem
- Hamza Abdul Majeed
- Julie Christina Abdullah
- Muneebah Abdullah
- Nicole Abdullah
All providers in Milwaukee, WI · Internal Medicine Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.