Makonnen G. Habtemariam, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

21618 Issued in AZ

Practice address

1800 E Van Buren St
Phoenix, AZ 85006-3742

Phone

(602) 251-8100

Fax

(480) 907-7097

NPI assigned

Apr 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Internal Medicine

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Faith Hospice Hospice, Phoenix, AZ, CCN 031588
• Lavender Hospice Hospice, Phoenix, AZ, CCN 031693

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Makonnen G Habtemariam PLLC

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1043547938
  Medicare reassignment NPD Authorized official
• Palliative Care Alliance, LLC

  • Home Health Agency
  • Tempe, AZ
  • NPI 1093137671
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lavender Hospice LLC

  • Community Based Hospice Care Agency
  • Phoenix, AZ
  • NPI 1982117305
  Care Compare affiliation
• Sacred Heart Hospice LLC

  • Community Based Hospice Care Agency
  • Phoenix, AZ
  • NPI 1437277100
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429833600000",
    "number": "1851357909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 11773",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "85248",
            "telephone_number": "480-907-7707",
            "fax_number": "480-907-7097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 E VAN BUREN ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850063742",
            "telephone_number": "602-251-8100",
            "fax_number": "480-907-7097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABTEMARIAM",
        "first_name": "MAKONNEN",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2015-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "21618",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AZ",
            "license": "21618",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "21618",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "331918",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mohammad Ali Habib, M.D.
• Naomi Grace Habib, MD
• Kathleen A Habig, LPC
• Jose Antonio Habre, LISAC
• Ronald Habros, MD
• Hassan Hachem, M.D.
• Hacienda Inc
• Hacienda Inc
• Hacienda Skilled Nursing Facility
• Hacienda Skilled Nursing Facility, Inc.

• Internal Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.