Individual provider Active NPI

Meheret Mekonnen, MD, MS

  • Student in an Organized Health Care Education/Training Program
  • Philadelphia, PA
National Provider Identifier
1619765880
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
833 Chestnut St FL 1
Philadelphia, PA 19107-4404
Phone
(215) 955-6776
Fax
(215) 923-1089
NPI assigned
Apr 28, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

833 Chestnut St FL 1
Philadelphia, PA 19107-4404

Mailing address

833 Chestnut St FL 1
Philadelphia, PA 19107-4404
Phone (215) 955-1085

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20250624001768 PA Order and Referring Only - Obstetrics/GynecologyPractitioner - Obstetrics/Gynecology 1951813161

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1745798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1619765880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT ST FL 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074404",
            "telephone_number": "215-955-1085",
            "fax_number": "215-955-5041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT ST FL 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074404",
            "telephone_number": "215-955-6776",
            "fax_number": "215-923-1089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEKONNEN",
        "first_name": "MEHERET",
        "credential": "MD, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-28",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.