NPIMap

Individual provider Active NPI

Lielt Kebede Derebew, MD

  • Hospitalist Physician
  • Lebanon, PA
National Provider Identifier
1679077895
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD475354 Issued in PA
Practice address
252 S 4TH St FL 3
Lebanon, PA 17042-6111
Phone
(717) 270-4876
Fax
(717) 270-3875
NPI assigned
Mar 21, 2018
Last updated
Sep 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X MD475354 PA
Hospitalist Physician 208M00000X MD475354 PA Primary

Addresses

Primary practice location

252 S 4TH St FL 3
Lebanon, PA 17042-6111

Mailing address

601 Memory LN
York, PA 17402-2231
Phone (717) 851-1405

Other practice location 1

501 East Main Street
WellSpan Hospitalists
Waynesboro, PA 17268-1726
Phone (717) 765-4000

Other practice location 2

112 North 7th Street
WellSpan Hospitalists
Chambersburg, PA 17201-1720
Phone (717) 217-4300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20210830000709 PA Practitioner - HospitalistPractitioner - Internal Medicine 3678978624 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

252 S 4TH St
FL 2
Lebanon, PA 17042-6111
Phone (717) 270-4876

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD475354PAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group Internal Medicine CurrentSince Aug 23, 2021 Accepting new patients
Wellspan Medical Group CurrentSince Aug 23, 2021 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Waynesboro Hospital Past Accepting new patients
The Chambersburg Hospital Past Accepting new patients

Locations

112 N 7th St
Chambersburg, PA 17201
Phone (717) 217-4300

169 Martin Ave
Ephrata, PA 17522
Phone (717) 733-0311

252 S 4th St
Fl 2
Lebanon, PA 17042
Phone (717) 270-3751

252 S 4th St
Fl 3
Lebanon, PA 17042
Phone (717) 270-4876

501 E Main St
Waynesboro, PA 17268
Phone (717) 765-3400

1600 S George St
York, PA 17403
Phone (717) 848-3615

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

601 Memory Ln
York, PA 17402
Phone (717) 851-6670

Interoperability endpoints

  • Direct secure messaging: lderebew276501@wellspan.direct-ci.com

Organizations & group practices 5

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.

Hospital & facility affiliations 7

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": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1679077895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MEMORY LN",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174022231",
            "telephone_number": "717-851-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 S 4TH ST FL 3",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170426111",
            "telephone_number": "717-270-4876",
            "fax_number": "717-270-3875"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 East Main Street",
            "address_2": "WellSpan Hospitalists",
            "address_purpose": "LOCATION",
            "city": "Waynesboro",
            "state": "PA",
            "postal_code": "172681726",
            "country_code": "US",
            "telephone_number": "717-765-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "112 North 7th Street",
            "address_2": "WellSpan Hospitalists",
            "address_purpose": "LOCATION",
            "city": "Chambersburg",
            "state": "PA",
            "postal_code": "172011720",
            "country_code": "US",
            "telephone_number": "717-217-4300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEREBEW",
        "first_name": "LIELT",
        "middle_name": "KEBEDE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-21",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD475354",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "MD475354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

Verify at the official NPI Registry.