Individual provider Active NPI

Adisalem Mulatu Teferi, MD

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1952032468
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
85037-20 Issued in WI
Practice address
4422 3Rd Ave
Bronx, NY 10457-2594
Phone
(718) 960-9000
NPI assigned
Jun 23, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 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
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 85037-20 WI Primary

Addresses

Primary practice location

4422 3Rd Ave
Bronx, NY 10457-2594

Mailing address

4422 3Rd Ave
Bronx, NY 10457-2545
Phone (718) 960-9000

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
I20241218003087 WI Practitioner - Internal Medicine 1153858923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Group practices
Apogee Medical Group Waukesha SCGroup PAC ID 1153670054, 43 clinicians

Practice addresses (Care Compare)

725 American Ave
Waukesha, WI 53188-5031
Phone (262) 928-5400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
85037-20WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group Waukesha, SC Multi-Specialty CurrentSince Dec 10, 2024 Accepting new patients

Locations

240 Maple Ave
Mukwonago, WI 53149
Phone (262) 928-1900

725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011

Interoperability endpoints

  • Direct secure messaging: adisalem.mulatu.teferi.1@18107.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1655942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1952032468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4422 3RD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104572545",
            "telephone_number": "718-960-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4422 3RD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104572594",
            "telephone_number": "718-960-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEFERI",
        "first_name": "ADISALEM MULATU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-23",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "85037-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.