Individual provider Active NPI

Ermias Ghebreyesus

  • Certified Registered Nurse Anesthetist
  • New York, NY
National Provider Identifier
1487010997
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
95000510 Issued in CA
Practice address
408 E 92ND St Apt 10D
New York, NY 10128-8102
Phone
(347) 738-0318
NPI assigned
Jan 13, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 599579-1 NY
Certified Registered Nurse Anesthetist 367500000X 95000510 CA Primary

Addresses

Primary practice location

408 E 92ND St Apt 10D
New York, NY 10128-8102

Mailing address

408 E 92ND St Apt 10D
New York, NY 10128-8102
Phone (347) 738-0318

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160610000441 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 0042517187 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

250 Hospital Pkwy
San Jose, CA 95119-1103
Phone (408) 972-3000

Merit-based Incentive Payment System (MIPS)

Final score
81.7 of 100Reported as group
Quality
70
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
599579-1NYMDRegistered Nurse
95000510CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Services of San Joaquin, P.C. CurrentSince Dec 31, 2017 Accepting new patients
Valley Regional Anesthesia Associates Inc CurrentSince Feb 28, 2024 Accepting new patients
Permanente Medical Group, Inc CurrentSince Dec 4, 2017 Accepting new patients
Regional Anesthesia Associates Inc CurrentSince Jul 6, 2021 Accepting new patients
Community Foundation Medical Group Current Accepting new patients
Cep America - Anesthesia PC CurrentSince Aug 1, 2021 Accepting new patients
Cep America - Anesthesia PC CurrentSince Aug 1, 2021 Accepting new patients
Community Foundation Medical Group CurrentSince Sep 1, 2021 Accepting new patients
Permanente Medical Group Inc CurrentSince Dec 4, 2017 Accepting new patients
Permanente Medical Group Inc Current Accepting new patients
Community Foundation Medical Group CurrentSince Sep 1, 2021 Accepting new patients
Cep America - Anesthesia, PC Current Accepting new patients
Cep America - Anesthesia PC Past Accepting new patients

Locations (25 of 46)

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

3001 Sillect Ave
Bakersfield, CA 93308
Phone (661) 316-6000

2615 Chester Ave
Bakersfield, CA 93301
Phone (661) 381-7545

1700 Mount Vernon Ave
Bakersfield, CA 93306
Phone (616) 326-2000

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

500 W Hospital Rd
French Camp, CA 95231
Phone (209) 468-6000

6125 N Fresno St
Fresno, CA 93710
Phone (559) 285-9344

2335 E Kashian Ln
Ste 270
Fresno, CA 93701
Phone (559) 445-1251

1843 E Fir Ave
Ste 104
Fresno, CA 93720
Phone (559) 323-6611

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

1630 E Herndon Ave
Ste 100
Fresno, CA 93720
Phone (559) 449-2888

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

27200 Calaroga Ave
Hayward, CA 94545
Phone (510) 264-2000

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

1660 W 3rd St
Los Angeles, CA 90017
Phone (213) 201-0850

1205 E North St
Manteca, CA 95336
Phone (209) 239-8301

145 Trevino Ave
Manteca, CA 95337
Phone (209) 788-8180

609 E Orangeburg Ave
Bldg B
Modesto, CA 95350
Phone (209) 527-6700

1441 Florida Ave
Modesto, CA 95350
Phone (209) 214-7235

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1300 Mable Ave
#1
Modesto, CA 95355
Phone (209) 571-1633

1300 Mable Ave
Ste 1
Modesto, CA 95355
Phone (209) 571-1633

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

465 W Putnam Ave
Porterville, CA 93257
Phone (559) 784-8886

2550 Sister Mary Columba Dr
Red Bluff, CA 96080
Phone (530) 529-8000

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1452643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1487010997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 E 92ND ST APT 10D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101288102",
            "telephone_number": "347-738-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 E 92ND ST APT 10D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101288102",
            "telephone_number": "347-738-0318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHEBREYESUS",
        "first_name": "ERMIAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-13",
        "last_updated": "2022-02-11",
        "certification_date": "2021-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "599579-1",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95000510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "250 Hospital Pkwy",
            "city": "San Jose",
            "state": "CA",
            "country_code": "US",
            "postal_code": "95119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.