Bereket T Woldemariam, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1501810 Issued in KS

Practice address

315 W 15TH St
Liberal, KS 67901-2455

Phone

(620) 629-6477

Fax

(620) 629-6651

NPI assigned

Apr 21, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MD, DC, VA3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Medicine Associates P.a., P.C.Group PAC ID 8022914522, 706 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carroll Hospital Center Hospital, Westminster, MD, CCN 210033
• Sinai Hospital of Baltimore Hospital, Baltimore, MD, CCN 210012
• Levindale Hebrew Geriatric Center and Hospital Hospital, Baltimore, MD, CCN 210064

Merit-based Incentive Payment System (MIPS)

Final score

81.6 of 100Reported as group

Quality

76.36

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Emergency Medicine Associates P.a., P.C.

  • Emergency Medicine Physician
  • Falls Church, VA
  • NPI 1134117393

  DC, MD

  Medicare reassignment Care Compare group NPD
• Emergency Medicine Associates, P.a.,P.C.

  • Internal Medicine Physician
  • Dulles, VA
  • NPI 1376917070
  Medicare reassignment
• Emergency Medicine Associates P.a., P.C.

  • Internal Medicine Physician
  • Culpeper, VA
  • NPI 1881559102
  NPD
• Emergency Medicine Associates, PA

  • Emergency Medicine Physician
  • Bowie, MD
  • NPI 1225889272
  NPD
• Emergency Medicine Associates, PA

  • Emergency Medicine Physician
  • Aberdeen, MD
  • NPI 1609627082
  NPD
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Oklahoma Hospitalist Partners, PLLC

  • Hospitalist Physician
  • Midwest City, OK
  • NPI 1588042212
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Carroll Hospital Center, Inc.

  • General Acute Care Hospital
  • Westminster, MD
  • NPI 1912904210
  Care Compare affiliation
• Levindale Hebrew Geriatric Center & Hospital Inc

  • Chronic Disease Hospital
  • Baltimore, MD
  • NPI 1598740821
  Care Compare affiliation
• Sinai Hospital of Baltimore, Inc.

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1285672204
  Care Compare affiliation
• Sinai Hospital of Baltimore, Inc.

  dba Grace Medical Center, A Sinai Hospital Facility

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1487325874
  Care Compare affiliation

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

{
    "created_epoch": "1429574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1578950119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1215",
            "address_2": "ATTN CLINIC BILLING OFFICE",
            "city": "LIBERAL",
            "state": "KS",
            "postal_code": "679051215",
            "telephone_number": "620-629-6638",
            "fax_number": "620-629-6684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W 15TH ST",
            "city": "LIBERAL",
            "state": "KS",
            "postal_code": "679012455",
            "telephone_number": "620-629-6477",
            "fax_number": "620-629-6651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLDEMARIAM",
        "first_name": "BEREKET",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-21",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "1501810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201129150A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200647940A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Walgreens #10722)
• Walmart Inc. (Walmart Pharmacy 10-0799)
• Waterside Case Management
• James Mitchell Wiley, DO
• Williams Medical Group Practice, LLC (Xpress Wellness Urgent Care)
• Linda G. Wolf, D.D.S.
• Womens Specialists of Liberal (Women's Specialists of Liberal, P.A.)
• Marcine M. Woods, LCMFT
• Jungmo Yang
• Kim A Yount, D.D.S.

• Physician Assistant in Liberal, KS
• Providers in Liberal, KS by specialty
• Physician Assistant in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.