Active NPI
Natenael Kebede Nesibu, DO
- Internal Medicine Physician
- Grand Rapids, MI
National Provider Identifier
1619781952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 5151017318
- Practice address
- 275 Michigan St NE FL 9
Grand Rapids, MI 49503-2531 - Phone
- (616) 391-3777
- Fax
- (616) 391-3755
- NPI assigned
- Feb 6, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | 5151017318 | MI | Primary |
Addresses
Primary practice location
275 Michigan St NE FL 9
Grand Rapids, MI 49503-2531
Mailing address
3778 Kinview St NW
Grand Rapids, MI 49534-2701
Other names 1
- Nati Nesibu
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250603003938 | MI | Order and Referring Only - Internal Medicine | 8224547971 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spectrum Health Hospitals | Internal Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1738800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750291200000",
"number": "1619781952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3778 KINVIEW ST NW",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495342701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 MICHIGAN ST NE FL 9",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032531",
"telephone_number": "616-391-3777",
"fax_number": "616-391-3755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NESIBU",
"first_name": "NATENAEL",
"middle_name": "KEBEDE",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-02-06",
"last_updated": "2025-06-19",
"certification_date": "2025-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "5151017318",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "NATI",
"last_name": "NESIBU",
"credential": "DO",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.