NPIMap

Individual provider Active NPI

Kalkidan Abebe, MD

  • Internal Medicine Physician
  • Tucson, AZ
National Provider Identifier
1508435504
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
72511 Issued in AZ
Practice address
1625 N Campbell Ave
Tucson, AZ 85719-4330
Phone
(520) 649-0111
NPI assigned
Jun 23, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 72511 AZ Primary

Addresses

Primary practice location

1625 N Campbell Ave
Tucson, AZ 85719-4330

Mailing address

1625 N Campbell Ave
Tucson, AZ 85719-4330
Phone (520) 649-0111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240910004758 AZ Practitioner - Internal Medicine 3173924768 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lakeside Heart and Vascular Center PLLCGroup PAC ID 4587832779, 20 clinicians
Banner-University Medical GroupGroup PAC ID 7719899871, 1,066 clinicians

Practice addresses (Care Compare)

1830 Mesquite Ave
Suite a
Lake Havasu City, AZ 86403-5885
Phone (928) 855-8071

7901 E 22ND St
Tucson, AZ 85710-8509
Phone (520) 694-5437

Hospital & facility affiliations

  • Bayada Home Health Care, Inc Home health agency, Tucson, AZ, CCN 037213
  • Banner - University Medical Center Tucson Campus Hospital, Tucson, AZ, CCN 030064
  • Havasu Regional Medical Center Hospital, Lake Havasu City, AZ, CCN 030069
  • Banner-University Medical Center South Campus Hospital, Tucson, AZ, CCN 030111

Merit-based Incentive Payment System (MIPS)

Final score
79.85 of 100Reported as group
Quality
60.31
Promoting interoperability
93
Improvement activities
40
Cost
78.37

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeside Heart and Vascular Center PLLC CurrentSince Aug 12, 2024 Accepting new patients
Banner-University Medical Group CurrentSince Aug 24, 2025 Accepting new patients
Banner-University Medical Group Internal Medicine Current Accepting new patients
Banner-University Medical Group CurrentSince Aug 24, 2025 Accepting new patients

Locations

1840 Mesquite Ave
Ste H
Lk Havasu Cty, AZ 86403
Phone (928) 855-4224

2082 Mesquite Ave
Ste 100A
Lk Havasu Cty, AZ 86403
Phone (928) 453-2828

1830 Mesquite Ave
Ste A
Lk Havasu Cty, AZ 86403
Phone (928) 453-4300

1987 McCulloch Blvd N
Ste 101
Lk Havasu Cty, AZ 86403
Phone (904) 994-5560

2800 E Ajo Way
Bldg 100
Tucson, AZ 85713
Phone (520) 419-5820

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

1625 N Campbell Ave
Tucson, AZ 85719

7901 E 22nd St
Tucson, AZ 85710
Phone (520) 694-8400

1501 N Campbell Ave
Rm 6336
Tucson, AZ 85724
Phone (520) 626-2761

Interoperability endpoints

  • Direct secure messaging: kalkidan.abebe.1@3291.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/3291/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1508435504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857194330",
            "telephone_number": "520-649-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857194330",
            "telephone_number": "520-649-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABEBE",
        "first_name": "KALKIDAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-23",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "72511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.