NPIMap

Individual provider Active NPI

Tesfaye Habtetsion Gebremedhin, M.D.

  • Internal Medicine Physician
  • Menomonee Falls, WI
National Provider Identifier
1780927657
Registry record updated Jun 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
63225 - 20 Issued in WI
Practice address
W180N8085 Town Hall Rd
Menomonee Falls, WI 53051-3518
Phone
(262) 251-1000
NPI assigned
Mar 29, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 63225 - 20 WI Primary

Addresses

Primary practice location

W180N8085 Town Hall Rd
Menomonee Falls, WI 53051-3518

Mailing address

2124 S Sanctuary Dr
New Berlin, WI 53151-1923
Phone (414) 688-4534

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20160718001163 WI Practitioner - Internal Medicine 5799077483 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Impact Physician Group, Wisconsin LLCGroup PAC ID 2466840004, 2 clinicians

Practice addresses (Care Compare)

10000 W Bluemound Rd
Wauwatosa, WI 53226-4321
Phone (414) 454-8000

3200 S 103Rd St
Milwaukee, WI 53227-4104
Phone (678) 967-5599

W180N8085 Town Hall Rd
FL 3
Menomonee Falls, WI 53051-3518
Phone (262) 251-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
63225 - 20WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical College of Wisconsin, Inc. Internal Medicine Current Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jun 5, 2016 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. Internal Medicine CurrentSince Jun 5, 2016 Accepting new patients
Maple Medical SC Internal Medicine CurrentSince Sep 1, 2021 Accepting new patients
Impact Physician Group, Wisconsin LLC Internal Medicine CurrentSince Jan 23, 2024 Accepting new patients
Oak Medical SC Internal Medicine CurrentSince Sep 1, 2021 Accepting new patients

Locations

21 Eastbrook Bnd
Ste 218
Peachtree Cty, GA 30269
Phone (260) 407-8007

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

W180N8085 Town Hall Rd
Fl 3
Menomonee Falls, WI 53051

W180N8085 Town Hall Rd
Menomonee Fls, WI 53051
Phone (262) 257-5000

3200 S 103rd St
Milwaukee, WI 53227
Phone (414) 440-0500

725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011

N20W22961 Watertown Rd
Waukesha, WI 53186
Phone (262) 875-5070

10000 W Bluemound Rd
Wauwatosa, WI 53226
Phone (414) 456-3000

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

Interoperability endpoints

  • Direct secure messaging: tgebremedhinmd200338@direct.froedtert.com

Organizations & group practices 6

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 8

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": "1364515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466467200000",
    "number": "1780927657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 S SANCTUARY DR",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531511923",
            "telephone_number": "414-688-4534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W180N8085 TOWN HALL RD",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530513518",
            "telephone_number": "262-251-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEBREMEDHIN",
        "first_name": "TESFAYE",
        "middle_name": "HABTETSION",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-29",
        "last_updated": "2016-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "63225 - 20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menomonee Falls, WI

Sources for this page

Verify at the official NPI Registry.