Individual provider Active NPI

Ayalnesh Shiferaw Tadele, MD

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1881275493
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101281540 Issued in VA
Practice address
6420 Clayton Rd
Saint Louis, MO 63117
Phone
(314) 768-8778
Fax
(314) 768-7101
NPI assigned
Apr 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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 0101281540 VA Primary

Addresses

Primary practice location

6420 Clayton Rd
Saint Louis, MO 63117

Mailing address

6215 Gum Street
Alexandria, VA 22310
Phone (571) 337-9595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20241017004156 DC Practitioner - Emergency Medicine 8022540830 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1701 N George Mason Dr
Arlington, VA 22205-3610
Phone (703) 558-5000

4320 Seminary Rd
Alexandria, VA 22304-1535
Phone (703) 504-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101281540VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates P.a., P.C. Internal Medicine CurrentSince Aug 20, 2024 Accepting new patients
Emergency Medicine Associates, PA CurrentSince Aug 20, 2024 Accepting new patients
Emergency Medicine Associates P.a., P.C. Current Accepting new patients
Inova Health Care Services Past Accepting new patients

Locations

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

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": "1618444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1881275493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6215 GUM STREET",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "22310",
            "telephone_number": "571-337-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 CLAYTON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63117",
            "telephone_number": "314-768-8778",
            "fax_number": "314-768-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TADELE",
        "first_name": "AYALNESH",
        "middle_name": "SHIFERAW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-15",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101281540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.