Adisu Tesfay Kiros

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

4711 W Ashlan Ave
Fresno, CA 93722-4307

Phone

(559) 203-6640

NPI assigned

Mar 20, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: adisu.kiros.p4@direct.vht.nextgenshare.com

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

{
    "created_epoch": "1710892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1720848427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 737",
            "city": "SAN JOAQUIN",
            "state": "CA",
            "postal_code": "936600737",
            "telephone_number": "559-203-6640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4711 W ASHLAN AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937224307",
            "telephone_number": "559-203-6640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIROS",
        "first_name": "ADISU",
        "middle_name": "TESFAY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-20",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirandeep K Batth M.D. Inc
• John Kirby, MD
• Patricia Kirby
• Elizabeth Kirkland
• Derek Alexander Kirmel
• Saby Kirpal, FNP
• Belinda Lopez Kirschbaum
• Daniel Adam Kirsten, MD
• Markham Kirsten, MD
• Carolyn Que Kishihara, OTR

• Student in an Organized Health Care Education/Training Program in Fresno, CA
• Providers in Fresno, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.