Individual provider Active NPI

Rediet Haileselassie, MD

  • General Practice Physician
  • Galveston, TX
National Provider Identifier
1710548763
Registry record updated Jun 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
T3476 Issued in TX
Practice address
301 University Blvd
Galveston, TX 77555-1250
Phone
(409) 744-4030
Fax
(409) 740-4187
NPI assigned
Jun 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X T3476 TX Primary
Family Medicine Physician 207Q00000X BP10067100 TX

Addresses

Primary practice location

301 University Blvd
Galveston, TX 77555-1250

Mailing address

301 University Blvd
Galveston, TX 77555-1250
Phone (409) 744-4030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20230110001279 TX Practitioner - Family Practice 2365778123 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, P.a. Family Medicine CurrentSince Dec 5, 2022 Accepting new patients
Wellmed Medical Group, PA Family Medicine CurrentSince Dec 5, 2022 Accepting new patients

Locations

3228 Interstate 30
Ste 200
Mesquite, TX 75150
Phone (972) 216-5400

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781827200000",
    "number": "1710548763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775551250",
            "telephone_number": "409-744-4030",
            "fax_number": "409-740-4187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775551250",
            "telephone_number": "409-744-4030",
            "fax_number": "409-740-4187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAILESELASSIE",
        "first_name": "REDIET",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-20",
        "last_updated": "2026-06-19",
        "certification_date": "2026-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "T3476",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "BP10067100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

Verify at the official NPI Registry.