Individual provider Active NPI

Samuel Kebede, MD

  • Internal Medicine Physician
  • Saint Paul, MN
National Provider Identifier
1790177129
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01081919A Issued in IN
Practice address
45 10TH St W
Saint Paul, MN 55102-1062
Phone
(651) 326-3700
Fax
(651) 326-3706
NPI assigned
Feb 23, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 01081919A IN
Internal Medicine Physician 207R00000X 01081919A IN Primary

Addresses

Primary practice location

45 10TH St W
Saint Paul, MN 55102-1062

Mailing address

8900 Van Wyck Expy
Jamaica, NY 11418-2832
Phone (718) 206-7708

Other practice location 1

8900 Van Wyck Expy
Jamaica, NY 11418-2832
Phone (718) 206-7708

Other practice location 2

1137 Liberty Rd
Eldersburg, MD 21784-7934
Phone (410) 795-0929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, MN, DC, MD4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20170919001528 VA Practitioner - HospitalistPractitioner - Internal Medicine 6204100977 Reassigns benefits to 3 organizations
I20190911000824 MN Practitioner - Internal Medicine 6204100977 Reassigns benefits to 2 organizations
I20210212001039 DC Practitioner - Internal Medicine 6204100977 Reassigns benefits to 1 organization
I20221022000274 MD Practitioner - Internal Medicine 6204100977 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Luminis Health Medical Group, LLCGroup PAC ID 2860447315, 540 clinicians

Practice addresses (Care Compare)

2001 Medical Pkwy
Annapolis, MD 21401-3280
Phone (443) 481-1000

Hospital & facility affiliations

  • Luminis Health Anne Arundel Medical Center, Inc Hospital, Annapolis, MD, CCN 210023

Merit-based Incentive Payment System (MIPS)

Final score
81.45 of 100Reported as group
Quality
67.28
Promoting interoperability
98
Improvement activities
40
Cost
72.57

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01081919AINMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Virginia - Richmond, LLC Internal Medicine CurrentSince Jan 1, 2020 Accepting new patients
Luminis Health Medical Group, LLC Current Accepting new patients
Luminis Health Medical Group, LLC Internal Medicine CurrentSince Jul 13, 2022 Accepting new patients
Fairview Health Services CurrentSince Oct 13, 2019 Accepting new patients
Central Primary Care LLC Internal Medicine Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Aug 23, 2019 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Jul 13, 2022 Accepting new patients
Medstar Medical Group II LLC CurrentSince Jan 1, 2021 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Express Care CurrentSince Oct 13, 2019 Accepting new patients
Hospitalist Medicine Physicians of Virginia LLC Internal Medicine CurrentSince Jan 16, 2019 Accepting new patients
Healtheast Medical Research Institute Internal Medicine CurrentSince Aug 23, 2019 Accepting new patients
Hospitalist Medicine Physicians of Fredericksburg, LLC Internal Medicine CurrentSince Sep 23, 2018 Accepting new patients
Medstar Medical Group II LLC Internal Medicine CurrentSince Jan 1, 2021 Accepting new patients
Luminis Health Anne Arundel Medical Center, Inc. Past Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

2003 Medical Pkwy
Ste 301
Annapolis, MD 21401
Phone (443) 481-3366

2001 Medical Pkwy
Annapolis, MD 21401
Phone (410) 280-5601

1630 Main St
Ste 213
Chester, MD 21619
Phone (443) 481-5300

7503 Surratts Rd
Clinton, MD 20735
Phone (301) 868-8000

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

400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203

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

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

69 Exchange St W
Saint Paul, MN 55102
Phone (651) 232-1100

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

8260 Atlee Rd
Mechanicsvlle, VA 23116
Phone (804) 264-6000

5801 Bremo Rd
Richmond, VA 23226
Phone (804) 281-8220

2300 Opitz Blvd
Ste G209
Woodbridge, VA 22191

759 S Main St
Woodstock, VA 22664
Phone (540) 459-1100

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 2

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": "1424649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1790177129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8900 VAN WYCK EXPY",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114182832",
            "telephone_number": "718-206-7708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 10TH ST W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551021062",
            "telephone_number": "651-326-3700",
            "fax_number": "651-326-3706"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8900 Van Wyck Expy",
            "address_purpose": "LOCATION",
            "city": "Jamaica",
            "state": "NY",
            "postal_code": "114182832",
            "country_code": "US",
            "telephone_number": "718-206-7708",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1137 Liberty Rd",
            "address_purpose": "LOCATION",
            "city": "Eldersburg",
            "state": "MD",
            "postal_code": "217847934",
            "country_code": "US",
            "telephone_number": "410-795-0929",
            "fax_number": "410-795-0149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEBEDE",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-23",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01081919A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01081919A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.