Individual provider Active NPI

Yohannes Ali Belachew, M.D

  • Internal Medicine Physician
  • Atlanta, GA
National Provider Identifier
1871586693
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
050940 Issued in GA
Practice address
3490 Clairmont Rd NE
Atlanta, GA 30319-3758
Phone
(404) 477-1218
Fax
(404) 477-1219
NPI assigned
Aug 26, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 050940 GA Primary

Addresses

Primary practice location

3490 Clairmont Rd NE
Atlanta, GA 30319-3758

Mailing address

3490 Clairmont Rd NE
Atlanta, GA 30319-3758
Phone (404) 477-1218

Other identifiers 1

IdentifierTypeStateIssuer
11SCDDCOtherGAPIN

Other names 1

  • Meskerem Belachew Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20040916000007 GA Practitioner - Internal Medicine 8022085448 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3490 Clairmont Rd NE
Atlanta, GA 30319-3758
Phone (404) 477-1218

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clairmont Medical Clinic LLC Belachew Yohannes a Ei Al MBR CurrentSince Apr 1, 2004 Accepting new patients

Locations

3490 Clairmont Rd NE
Brookhaven, GA 30319
Phone (404) 477-1218

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871586693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3490 CLAIRMONT RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303193758",
            "telephone_number": "404-477-1218",
            "fax_number": "404-477-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3490 CLAIRMONT RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303193758",
            "telephone_number": "404-477-1218",
            "fax_number": "404-477-1219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELACHEW",
        "first_name": "YOHANNES",
        "middle_name": "ALI",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "050940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIN",
            "identifier": "11SCDDC",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MESKEREM",
            "last_name": "BELACHEW",
            "credential": "M.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.