Individual provider Active NPI

Haftu K. Gebrehiwot, M.D

  • Family Medicine Physician
  • Aurora, CO
National Provider Identifier
1568664860
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
46877 Issued in CO
Practice address
13901 E. Exposition Avenue
Suite 230
Aurora, CO 80012-2535
Phone
(303) 364-1422
Fax
(303) 364-1454
NPI assigned
May 31, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 46877 CO Primary

Addresses

Primary practice location

13901 E. Exposition Avenue
Suite 230
Aurora, CO 80012-2535

Mailing address

13901 E. Exposition Avenue
Suite 230
Aurora, CO 80012-2535
Phone (303) 364-1422

Other identifiers 1

IdentifierTypeStateIssuer
66829810MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20090325000586 CO Practitioner - Family Practice 3274690813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11275 E Mississippi Ave
Suite 2E2
Aurora, CO 80012-2824
Phone (303) 364-1422

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46877COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Romanat Clinic, Inc CurrentSince Dec 1, 2010 Accepting new patients
Morgan Community Walk- in Clinic PastSince Feb 27, 2009 Accepting new patients
Colorado Plains Physician Practices LLC Family Medicine Past Accepting new patients

Locations

13901 E Exposition Ave
Ste 230
Aurora, CO 80012
Phone (303) 364-1422

11275 E Mississippi Ave
Ste 2S3
Aurora, CO 80012
Phone (303) 364-1422

11275 E Mississippi Ave
Ste 2E2
Aurora, CO 80012
Phone (303) 364-1422

Organizations & group practices 3

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": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1568664860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13901 E. EXPOSITION AVENUE",
            "address_2": "SUITE 230",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800122535",
            "telephone_number": "303-364-1422",
            "fax_number": "303-364-1454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13901 E. EXPOSITION AVENUE",
            "address_2": "SUITE 230",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800122535",
            "telephone_number": "303-364-1422",
            "fax_number": "303-364-1454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEBREHIWOT",
        "first_name": "HAFTU",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-31",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "46877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "66829810",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.