Individual provider Active NPI

Yohannes Gebre, M.D.

  • Family Medicine Physician
  • Saint Paul, MN
National Provider Identifier
1720084783
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
40937 Issued in MN
Practice address
1821 University Ave W
Ste S206
Saint Paul, MN 55104-2893
Phone
(651) 644-2273
Fax
(651) 659-2273
NPI assigned
Jun 23, 2005
Reactivated
Mar 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 40937 MN Primary

Addresses

Primary practice location

1821 University Ave W
Ste S206
Saint Paul, MN 55104-2893

Mailing address

1821 University Ave W
Ste S206
Saint Paul, MN 55104-2893
Phone (651) 644-2273

Other practice location 1

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-7800

Other identifiers 1

IdentifierTypeStateIssuer
074818800MedicaidMN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ygebre92267@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20041111000176 MN Practitioner - Family Practice 2365340676 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (651) 262-7633

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
40937MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics CurrentSince Feb 1, 2014 Accepting new patients
Allina Health System CurrentSince Jun 9, 2023 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Clinics CurrentSince Feb 1, 2014 Accepting new patients
Fairview Health Services CurrentSince May 1, 2008 Accepting new patients
Allina Health System Current Accepting new patients
Fairview Clinics Current Accepting new patients
Allina Health System CurrentSince Jun 9, 2023 Accepting new patients
Fairview Clinics CurrentSince May 1, 2008 Accepting new patients
Midway Family Clinic PA Family Medicine PastSince Apr 28, 2004 Accepting new patients
Camden Physicians LTD. Family Medicine Past Accepting new patients

Locations

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

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

400 Stinson Blvd
#2
Minneapolis, MN 55413
Phone (612) 672-2294

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

420 Delaware St SE
#126
Minneapolis, MN 55455
Phone (612) 626-2378

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

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

4000 Central Ave NE
Saint Anthony, MN 55421
Phone (763) 572-5700

Organizations & group practices 12

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": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1720084783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 UNIVERSITY AVE W",
            "address_2": "STE S206",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551042893",
            "telephone_number": "651-644-2273",
            "fax_number": "651-659-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 UNIVERSITY AVE W",
            "address_2": "STE S206",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551042893",
            "telephone_number": "651-644-2273",
            "fax_number": "651-659-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2925 Chicago Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554071321",
            "country_code": "US",
            "telephone_number": "612-262-7800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEBRE",
        "first_name": "YOHANNES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "deactivation_date": "2006-03-16",
        "reactivation_date": "2006-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "40937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "074818800",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ygebre92267@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "2925 Chicago Ave",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554071321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.