NPIMap

Individual provider Active NPI

Abraham Deneke Bezuneh, M.D.

  • Hospitalist Physician
  • Brooklyn, NY
National Provider Identifier
1508238130
Registry record updated May 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
2018023697 Issued in MO
Practice address
1545 Atlantic Ave
Brooklyn, NY 11213
Phone
(718) 613-4000
NPI assigned
Oct 22, 2015
Last updated
May 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 036153174 IL
Hospitalist Physician 208M00000X 036153174 IL
Hospitalist Physician 208M00000X 2018023697 MO Primary

Addresses

Primary practice location

1545 Atlantic Ave
Brooklyn, NY 11213

Mailing address

1545 Atlantic Ave
Brooklyn, NY 11213-1122
Phone (718) 613-4000

Other practice location 1

1 Memorial Dr
Alton, IL 62002-6722
Phone (618) 463-7240

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180710000994 MO Practitioner - HospitalistPractitioner - Internal Medicine 4385990183 Reassigns benefits to 4 organizations
I20220603001120 IL Practitioner - HospitalistPractitioner - Internal Medicine 4385990183 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Heights Medical Group SCGroup PAC ID 6800784083, 448 clinicians
Sound Physicians of Illinois LLCGroup PAC ID 1557533734, 193 clinicians
24 On Physicians PCGroup PAC ID 5698688141, 274 clinicians

Practice addresses (Care Compare)

1 Memorial Dr
Alton, IL 62002-6722
Phone (618) 463-7240

100 Medical PLZ
Lake Saint Louis, MO 63367-1366
Phone (636) 625-5200

12303 De Paul Dr
Bridgeton, MO 63044-2512
Phone (314) 344-6000

201 S 14TH St
Herrin, IL 62948-3631
Phone (618) 942-2171

6420 Clayton Rd
Richmond Heights, MO 63117-1811
Phone (314) 768-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036153174ILMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians of Illinois, LLC Internal Medicine CurrentSince Jul 1, 2018 Accepting new patients
Fairview Heights Medical Group SC CurrentSince Jun 1, 2022 Accepting new patients
Galen Inpatient Physicians PC Hospitalist CurrentSince Apr 27, 2020 Accepting new patients
Missouri Baptist Hospital of Sullivan CurrentSince Mar 17, 2024 Accepting new patients
Missouri Baptist Hospital of Sullivan Current Accepting new patients
24 On Physicians, PC Hospitalist CurrentSince Mar 1, 2023 Accepting new patients
Galen Inpatient Physicians PC. Internal Medicine CurrentSince Apr 27, 2020 Accepting new patients
Fairview Heights Medical Group SC CurrentSince Jun 1, 2022 Accepting new patients
Cogent Healthcare of Missouri, Inc CurrentSince Jan 1, 2022 Accepting new patients
24 On Physicians, P.C. Hospitalist CurrentSince Mar 1, 2023 Accepting new patients
Missouri Baptist Hospital of Sullivan CurrentSince Mar 17, 2024 Accepting new patients
SSM Health Care St. Louis Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

13000 Deerfield Pkwy
Ste 100
Alpharetta, GA 30004

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

4500 Memorial Dr
Belleville, IL 62226
Phone (618) 233-7750

405 W Jackson St
Carbondale, IL 62901

201 S 14th St
Herrin, IL 62948
Phone (618) 942-2171

1100 E Norris Dr
Ottawa, IL 61350
Phone (815) 416-1224

12303 De Paul Dr
Bridgeton, MO 63044
Phone (314) 344-6360

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

300 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 669-2211

6420 Clayton Rd
Saint Louis, MO 63117
Phone (314) 768-8442

751 Sappington Bridge Rd
Sullivan, MO 63080
Phone (573) 468-1343

965 Mattox Dr
Sullivan, MO 63080
Phone (573) 468-7054

Interoperability endpoints

  • Direct secure messaging: abezuneh68261@sih.direct-ci.com
  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 12

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 7

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": "1445472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652054400000",
    "number": "1508238130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 ATLANTIC AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112131122",
            "telephone_number": "718-613-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 ATLANTIC AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11213",
            "telephone_number": "718-613-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Alton",
            "state": "IL",
            "postal_code": "620026722",
            "country_code": "US",
            "telephone_number": "618-463-7240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEZUNEH",
        "first_name": "ABRAHAM",
        "middle_name": "DENEKE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-22",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036153174",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036153174",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "2018023697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1 Memorial Dr",
            "city": "Alton",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620026722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.