Individual provider Active NPI

Alay Gebremedhin Tikue, MD

  • Gastroenterology Physician
  • Eau Claire, WI
National Provider Identifier
1831676147
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
83672 Issued in WI
Practice address
1400 Bellinger St
Eau Claire, WI 54703-5222
Phone
(715) 838-5222
NPI assigned
Jul 20, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Gastroenterology Physician 207RG0100X 83672 WI Primary

Addresses

Primary practice location

1400 Bellinger St
Eau Claire, WI 54703-5222

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other practice location 1

3601 4th St # MS 9410
Lubbock, TX 79430-0002
Phone (800) 674-3179

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address atikue2257454@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240822000892 WI Practitioner - Gastroenterology 1557800588 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo Clinic Health System-Northwest Wisconsin Region IncGroup PAC ID 4385553627, shared by 21 NPIs, 797 clinicians

Practice addresses (Care Compare)

1400 Bellinger St
Eau Claire, WI 54703-5222
Phone (715) 838-5222

Hospital & facility affiliations

  • Mayo Clinic Health System Eau Claire Hospital Hospital, Eau Claire, WI, CCN 520070
  • Mayo Clinic Health System-Northland Hospital, Barron, WI, CCN 521315
  • Mayo Clinic Health System-Red Cedar Inc Hospital, Menomonie, WI, CCN 521340
  • Mayo Clinic Health System Chippewa Valley Hospital, Bloomer, WI, CCN 521314

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy92
Upper gastrointestinal (GI) endoscopy for acid reflux110

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
83672WIMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Current Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Current Accepting new patients

Locations

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

1222 E Woodland Ave
Barron, WI 54812
Phone (715) 537-3166

1501 Thompson St
Bloomer, WI 54724
Phone (715) 568-2000

733 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 838-3806

1400 Bellinger St
Eau Claire, WI 54703
Phone (715) 838-3311

Organizations & group practices 4

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 4

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": "1532044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1831676147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 BELLINGER ST",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547035222",
            "telephone_number": "715-838-5222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 4th St # MS 9410",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794300002",
            "country_code": "US",
            "telephone_number": "800-674-3179",
            "fax_number": "806-743-3143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIKUE",
        "first_name": "ALAY",
        "middle_name": "GEBREMEDHIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-20",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WI",
            "license": "83672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "atikue2257454@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "1400 Bellinger St",
            "city": "Eau Claire",
            "state": "WI",
            "country_code": "US",
            "postal_code": "547035222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

Verify at the official NPI Registry.