Individual provider Active NPI

Addisalem Melakehiwot Regassa, MD

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1902825870
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
220574 Issued in NY
Practice address
1873 Eastern Pkwy
Brooklyn, NY 11233-3214
Phone
(718) 240-8700
NPI assigned
Jul 19, 2006
Last updated
May 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2020

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 220574 NY Primary

Addresses

Primary practice location

1873 Eastern Pkwy
Brooklyn, NY 11233-3214

Mailing address

One Brookdale Plaza
Physician Enterprise
Brooklyn, NY 11212-4230
Phone (718) 240-7143

Other identifiers 1

IdentifierTypeStateIssuer
01801409MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20071022000584 NY Practitioner - Internal Medicine 0446341663 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interfaith Professional Physician Services PCGroup PAC ID 9931378171, 383 clinicians

Practice addresses (Care Compare)

1545 Atlantic Ave
Brooklyn, NY 11213-1122
Phone (718) 613-4000

2554 Linden Blvd
Brooklyn, NY 11208-4904
Phone (718) 240-5132

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Urban Strategies Brookdale Family Care Center Inc Internal Medicine CurrentSince Jan 1, 1998 Accepting new patients
Interfaith Emergency Medicine, P.C. Current Accepting new patients
Interfaith Professional Physician Services, P.C. Internal Medicine CurrentSince Jun 1, 2024 Accepting new patients
The Brookdale Hospital Medical Center CurrentSince Mar 26, 2012 Accepting new patients
Brookdale Hospital Medical Center CurrentSince Mar 26, 2012 Accepting new patients

Locations

1 Brookdale Plz
Brooklyn, NY 11212
Phone (718) 240-5212

1235 Linden Blvd
Fl 2
Brooklyn, NY 11212
Phone (718) 240-7143

1545 Atlantic Ave
Brooklyn, NY 11213
Phone (718) 613-4175

1873 Eastern Pkwy
Brooklyn, NY 11233
Phone (718) 240-5133

2554 Linden Blvd
Brooklyn, NY 11208
Phone (718) 240-5132

465 New Lots Ave
Brooklyn, NY 11207
Phone (718) 240-5133

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 6

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 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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1902825870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE BROOKDALE PLAZA",
            "address_2": "PHYSICIAN ENTERPRISE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112124230",
            "telephone_number": "718-240-7143",
            "fax_number": "718-240-5808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1873 EASTERN PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112333214",
            "telephone_number": "718-240-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELAKEHIWOT REGASSA",
        "first_name": "ADDISALEM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "220574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01801409",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.