Zewdu Lissanu, M.D.

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

36828 Issued in KY

Practice address

125 Greenbriar Dr
Campbellsville, KY 42718-9616

Phone

(270) 789-0247

NPI assigned

Feb 7, 2006

Last updated

Dec 11, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

73.96 of 100Reported as group

Quality

62.41

Promoting interoperability

69

Improvement activities

40

Cost

71.3

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Taylor Regional Medical Group,LLC

  dba Taylor Regional Women for Women

  • Obstetrics & Gynecology Physician
  • Campbellsville, KY
  • NPI 1174697601
  Medicare reassignment NPD
• Taylor Regional Medical Group

  dba Taylor Regional Oncology

  • Hematology & Oncology Physician
  • Campbellsville, KY
  • NPI 1205017464
  NPD
• Taylor Regional Medical Group LLC

  dba Taylor Regional Hospital Health Clinic

  • Rural Health Clinic/Center
  • Campbellsville, KY
  • NPI 1073370185
  NPD
• Emergency Medicine Associates

  • Emergency Medicine Physician
  • Reston, VA
  • NPI 1861892879
  NPD (past)
• Emergency Medicine Associates P.a., P.C.

  • Emergency Medicine Physician
  • Falls Church, VA
  • NPI 1134117393
  NPD (past)

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386720000000",
    "number": "1770556235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1698 OLD LEBANON RD",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427189662",
            "telephone_number": "270-789-0247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 GREENBRIAR DR",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427189616",
            "telephone_number": "270-789-0247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISSANU",
        "first_name": "ZEWDU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2013-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "KY",
            "license": "36828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64032188",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shana R Lawson, LPCA
• Heidi L. Lee, APRN
• Ryan David Lee, LAT, ATC
• Legacy Recovery for Women
• Leslie N Richardson, O.D. PSC
• Jake Thomas Logsdon, TCADC
• Tracy Lee Lott, MS, ATC
• Heather Loy, APRN
• Lumina of Campbellsville
• M&M Physical Therapy Inc.

• Hematology & Oncology Physician in Campbellsville, KY
• Providers in Campbellsville, KY by specialty
• Hematology & Oncology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.