Individual provider Active NPI

Fisseha Bayou, M.D.

  • Hospitalist Physician
  • Fredericksburg, VA
National Provider Identifier
1467848325
Registry record updated Apr 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
0101264148 Issued in VA
Practice address
1001 Sam Perry Blvd
Fredericksburg, VA 22401-4453
Phone
(540) 751-1100
NPI assigned
Apr 7, 2015
Last updated
Apr 15, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 0101264148 VA Primary

Addresses

Primary practice location

1001 Sam Perry Blvd
Fredericksburg, VA 22401-4453

Mailing address

585 Schenectady Ave
Brooklyn, NY 11203-1851
Phone (718) 604-5401

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180616000062 VA Practitioner - Internal Medicine 9335464098 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Intensivist Services PCGroup PAC ID 9335152107, 234 clinicians

Practice addresses (Care Compare)

7101 Jahnke Rd
Richmond, VA 23225-4017
Phone (804) 320-3911

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101264148VAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Washington Healthcare Providers LLC Hospitalist CurrentSince Jul 1, 2018 Accepting new patients
Southeastern Intensivist Services PC Hospitalist CurrentSince Dec 10, 2023 Accepting new patients

Locations

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

1401 Johnston Willis Dr
North Chesterfield, VA 23235
Phone (804) 327-4046

7101 Jahnke Rd
Richmond, VA 23225
Phone (804) 323-1088

125 Hospital Center Blvd
Stafford, VA 22554
Phone (540) 602-6500

Organizations & group practices 2

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.

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": "1428364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586908800000",
    "number": "1467848325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 SCHENECTADY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112031851",
            "telephone_number": "718-604-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 SAM PERRY BLVD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224014453",
            "telephone_number": "540-751-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAYOU",
        "first_name": "FISSEHA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-07",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0101264148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.