Kasebaoth Mekonnen

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

D87772 Issued in MD

Practice address

1411 E 31St St
Emergency Department Ahs Highland Campus/Qic 22123
Oakland, CA 94602-1018

Phone

(510) 437-8356

NPI assigned

Apr 1, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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

Merit-based Incentive Payment System (MIPS)

Final score

91.67 of 100Reported as group

Quality

90.2

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• Commonwealth Emergency Physicians PC

  • Emergency Medicine Physician
  • Leesburg, VA
  • NPI 1598723082
  Medicare reassignment NPD
• Commonwealth Emergency Physicians PC

  • Physician Assistant
  • Leesburg, VA
  • NPI 1366061574
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1427846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562544000000",
    "number": "1467847855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 E 31ST ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946021018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 E 31ST ST",
            "address_2": "EMERGENCY DEPARTMENT AHS HIGHLAND CAMPUS/QIC 22123",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946021018",
            "telephone_number": "510-437-8356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEKONNEN",
        "first_name": "KASEBAOTH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-01",
        "last_updated": "2019-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D87772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lesli Chasel Mejia
• Samantha Rubi Mejia
• Viola Mejia
• Wendy Jocelyn Mejiadias
• Rita Chigozie Mekkam, MPA, PA-C
• Sefanit Fisseha Mekuria, M.D.
• Galina Melamed
• Katherine Melena
• Ana Melendez
• Evelyn Rosario Melendez, LCSW

• Emergency Medicine Physician in Oakland, CA
• Providers in Oakland, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.