Individual provider Active NPI

Selamawit Abeibie

  • Internal Medicine Physician
  • Elyria, OH
National Provider Identifier
1477042117
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.143215 Issued in OH
Practice address
630 E River St
Elyria, OH 44035-5902
Phone
(440) 329-7500
NPI assigned
May 8, 2018
Last updated
Aug 24, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X 35.143215 OH Primary

Addresses

Primary practice location

630 E River St
Elyria, OH 44035-5902

Mailing address

630 E River St
Elyria, OH 44035-5902
Phone (440) 329-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20210909002489 OH Practitioner - Internal Medicine 5890030118 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.19 of 100Reported as group
Quality
63.13
Promoting interoperability
100
Improvement activities
40
Cost
74.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.143215OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hni Medical Services of Ohio, LLC Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients
Community Hospitalist, LLC Internal Medicine CurrentSince Oct 1, 2021 Accepting new patients
University Hospitals Medical Group Inc CurrentSince Apr 1, 2023 Accepting new patients
DRS Russell Berkebile and Associates Inc PastSince Oct 1, 2021 Accepting new patients

Locations

11100 Euclid Ave
Cleveland Heights, OH 44106

630 E River St
Elyria, OH 44035
Phone (440) 329-7450

3700 Kolbe Rd
Lorain, OH 44053
Phone (440) 331-9520

18697 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-8000

27100 Chardon Rd
Richmond Hts, OH 44143
Phone (440) 585-6000

30575 Bainbridge Rd
Ste 200
Solon, OH 44139

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

NPI Registry JSON

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

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1477042117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 E RIVER ST",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440355902",
            "telephone_number": "440-329-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 E RIVER ST",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440355902",
            "telephone_number": "440-329-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABEIBIE",
        "first_name": "SELAMAWIT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-08",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.143215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elyria, OH

Sources for this page

Verify at the official NPI Registry.