Abenet Bonger Beyene, NURSE PRACTITIONER

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

SP021458 Issued in PA

Practice address

126 N Cedar LN
Upper Darby, PA 19082-1306

Phone

(484) 784-8145

NPI assigned

Feb 12, 2020

Last updated

Feb 12, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1581465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1982236477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 N CEDAR LN",
            "city": "UPPER DARBY",
            "state": "PA",
            "postal_code": "190821306",
            "telephone_number": "484-784-8145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 N CEDAR LN",
            "city": "UPPER DARBY",
            "state": "PA",
            "postal_code": "190821306",
            "telephone_number": "484-784-8145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEYENE",
        "first_name": "ABENET",
        "middle_name": "BONGER",
        "name_prefix": "Mr.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-12",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "SP021458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Upper Darby, PA
• Providers in Upper Darby, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.