NPIMap

Individual provider Active NPI

Fikadu Gebreyes Tekleyes, MD

  • Cardiovascular Disease Physician
  • Newark, OH
National Provider Identifier
1679787386
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
35.129008 Issued in OH
Practice address
1320 W Main St
Newark, OH 43055
Phone
(220) 564-7750
Fax
(220) 564-7751
NPI assigned
May 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 35.129008 OH Primary

Addresses

Primary practice location

1320 W Main St
Newark, OH 43055

Mailing address

1320 W Main St
Newark, OH 43055
Phone (220) 564-7750

Other identifiers 5

IdentifierTypeStateIssuer
7100038120MedicaidKY
3810010703MedicaidWV
2797997MedicaidOH
613154600OtherWVBLACK LUNG/FECA
P00836670OtherWVRR MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ftekleyes14431@lickingmemorial.medicity.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20160915001154 OH Practitioner - Cardiovascular Disease (Cardiology) 6507948361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Licking Memorial Health ProfessionalsGroup PAC ID 6204740731, 235 clinicians

Practice addresses (Care Compare)

1320 W Main St
Licking Memorial Anesthesiology
Newark, OH 43055-1822
Phone (220) 564-4226

Hospital & facility affiliations

  • Licking Memorial Hospital Hospital, Newark, OH, CCN 360218
  • Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006
  • Ohio State University State Health System Hospital, Columbus, OH, CCN 360085

Merit-based Incentive Payment System (MIPS)

Final score
85.98 of 100Reported as group
Quality
75.66
Promoting interoperability
100
Improvement activities
40
Cost
75.38

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Licking Memorial Professional Corporation CurrentSince Aug 15, 2016 Accepting new patients
Licking Memorial Hospital Current Accepting new patients
Licking Memorial Health Professionals CurrentSince Aug 15, 2016 Accepting new patients
Licking Memorial Professional Corp. Past Accepting new patients
Licking Memorial Professional Corp. Past Accepting new patients

Locations

1320 W Main St
Newark, OH 43055
Phone (740) 348-4151

120 McMillen Dr
Newark, OH 43055
Phone (220) 564-4806

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1679787386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 W MAIN ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "43055",
            "telephone_number": "220-564-7750",
            "fax_number": "220-564-7751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 W MAIN ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "43055",
            "telephone_number": "220-564-7750",
            "fax_number": "220-564-7751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEKLEYES",
        "first_name": "FIKADU",
        "middle_name": "GEBREYES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35.129008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100038120",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810010703",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2797997",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG/FECA",
            "identifier": "613154600",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00836670",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ftekleyes14431@lickingmemorial.medicity.net",
            "affiliation": "N",
            "address_1": "1320 W Main St",
            "city": "Newark",
            "state": "OH",
            "country_code": "US",
            "postal_code": "43055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

Verify at the official NPI Registry.