NPIMap

Individual provider Active NPI

Tadesse Beyene, MD

  • Nephrology Physician
  • Livonia, MI
National Provider Identifier
1821239302
Registry record updated May 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
4301092774 Issued in MI
Practice address
36123 Schoolcraft Rd
Livonia, MI 48150
Phone
(734) 793-6140
Fax
(734) 402-0254
NPI assigned
Mar 13, 2009
Last updated
May 15, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301092774 MI
Nephrology Physician 207RN0300X 4301092774 MI Primary

Addresses

Primary practice location

36123 Schoolcraft Rd
Livonia, MI 48150

Mailing address

4572 Ranch LN
Bloomfield Hills, MI 48302-2440
Phone (773) 209-3378

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20130219000005 MI Practitioner - NephrologyPractitioner - Internal Medicine 4688823396 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4160 John R St
Suite 1011
Detroit, MI 48201-2017
Phone (313) 341-1431

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
T-Beyene Hypertension & Kidney Care PLC Nephrology CurrentSince Oct 4, 2016 Accepting new patients
Henry Ford Health System Current Accepting new patients
Inpatient Consultants of Michigan PC Internal Medicine CurrentSince Aug 1, 2016 Accepting new patients
Henry Ford Health System Internal Medicine CurrentSince Jul 1, 2016 Accepting new patients
Henry Ford Health System CurrentSince Jul 1, 2016 Accepting new patients

Locations

1014 E Grand River Ave
Brighton, MI 48116
Phone (810) 220-5222

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

1 William Carls Dr
Commerce Twp, MI 48382
Phone (248) 227-5500

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

4160 John R St
Ste 1011
Detroit, MI 48201
Phone (313) 341-1431

36123 Schoolcraft Rd
Livonia, MI 48150
Phone (734) 793-6140

Interoperability endpoints

  • Direct secure messaging: tbeyene@direct.dmc.org

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1236902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526342400000",
    "number": "1821239302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4572 RANCH LN",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483022440",
            "telephone_number": "773-209-3378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36123 SCHOOLCRAFT RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "48150",
            "telephone_number": "734-793-6140",
            "fax_number": "734-402-0254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEYENE",
        "first_name": "TADESSE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-13",
        "last_updated": "2018-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301092774",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MI",
            "license": "4301092774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.