Individual provider Active NPI

Mulubrhan Zewde, N.P.

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1801054093
Registry record updated Jul 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F330965 Issued in NY
Practice address
1111 Amsterdam Ave
Scrymser 3Rd Floor
New York, NY 10025-1716
Phone
(212) 523-6500
Fax
(212) 523-5677
NPI assigned
May 25, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F330965 NY Primary

Addresses

Primary practice location

1111 Amsterdam Ave
Scrymser 3Rd Floor
New York, NY 10025-1716

Mailing address

1111 Amsterdam Ave
Scrymser 3Rd Floor
New York, NY 10025-1716
Phone (212) 523-6500

Other identifiers 1

IdentifierTypeStateIssuer
01748049MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040816000205 NY Practitioner - Nurse Practitioner 2264405620

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F330965NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincents Hospital and Medical Center Past Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients
TBHC Medical Services PC Past Accepting new patients

Organizations & group practices 3

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": "1211673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436140800000",
    "number": "1801054093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 AMSTERDAM AVE",
            "address_2": "SCRYMSER 3RD FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251716",
            "telephone_number": "212-523-6500",
            "fax_number": "212-523-5677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 AMSTERDAM AVE",
            "address_2": "SCRYMSER 3RD FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251716",
            "telephone_number": "212-523-6500",
            "fax_number": "212-523-5677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEWDE",
        "first_name": "MULUBRHAN",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-25",
        "last_updated": "2015-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F330965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01748049",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.