NPIMap

Individual provider Active NPI

Yetmwork Berhanu, M,D

  • Internal Medicine Physician
  • Maple Grove, MN
National Provider Identifier
1639484843
Registry record updated Dec 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
54899 Issued in MN
Practice address
9875 Hospital Dr
Maple Grove, MN 55369-4648
Phone
(763) 581-1000
NPI assigned
Aug 11, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 54899 MN Primary

Addresses

Primary practice location

9875 Hospital Dr
Maple Grove, MN 55369-4648

Mailing address

9875 Hospital Dr
Maple Grove, MN 55369-4648
Phone (763) 581-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120813000244 MN Practitioner - Internal Medicine 1658527338 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Memorial Health CareGroup PAC ID 0042123028, 502 clinicians

Practice addresses (Care Compare)

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 581-5400

9855 Hospital Dr
Maple Grove, MN 55369-4648

9875 Hospital Dr
Maple Grove, MN 55369-4648
Phone (763) 581-1000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Memorial Health Care CurrentSince Jul 1, 2021 Accepting new patients
Fairview Health Services Internal Medicine CurrentSince Jul 13, 2012 Accepting new patients
Healtheast Medical Research Institute CurrentSince Sep 1, 2016 Accepting new patients
North Memorial Health Care Current Accepting new patients
Fairview Health Services Current Accepting new patients
Regency Hospital of Minneapolis, LLC CurrentSince Jan 21, 2019 Accepting new patients
Healtheast Medical Research Institute Internal Medicine CurrentSince Sep 1, 2016 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Health Services CurrentSince Jul 13, 2012 Accepting new patients
North Memorial Health Care CurrentSince Jul 1, 2021 Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

9875 Hospital Dr
Maple Grove, MN 55369
Phone (763) 581-1000

1300 Hidden Lakes Pkwy
Minneapolis, MN 55422
Phone (763) 588-2750

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

69 Exchange St W
Saint Paul, MN 55102
Phone (651) 232-1100

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

4714 Gettysburg Rd
Mechanicsburg, PA 17055
Phone (888) 735-6332

Organizations & group practices 11

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356652800000",
    "number": "1639484843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9875 HOSPITAL DR",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694648",
            "telephone_number": "763-581-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9875 HOSPITAL DR",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694648",
            "telephone_number": "763-581-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERHANU",
        "first_name": "YETMWORK",
        "credential": "M,D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-11",
        "last_updated": "2012-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "54899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.