Individual provider Active NPI

Hana Mengistu Mekonnen, RN

  • Registered Nurse
  • Beaverton, OR
National Provider Identifier
1518558774
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
202001158 Issued in OR
Practice address
5033 SW 206TH PL
Beaverton, OR 97078
Phone
(571) 447-2134
NPI assigned
Jan 31, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 202001158 OR Primary

Addresses

Primary practice location

5033 SW 206TH PL
Beaverton, OR 97078

Mailing address

5033 SW 206TH PL
Beaverton, OR 97078
Phone (571) 447-2134

Other names 1

  • Hana Mengistu Habtemariam Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
202001158ORMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1612051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1518558774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5033 SW 206TH PL",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "97078",
            "telephone_number": "571-447-2134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5033 SW 206TH PL",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "97078",
            "telephone_number": "571-447-2134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEKONNEN",
        "first_name": "HANA",
        "middle_name": "MENGISTU",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-31",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "202001158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HANA",
            "last_name": "HABTEMARIAM",
            "middle_name": "MENGISTU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.