Individual provider Active NPI

Worku B Zewdu, M.D.

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Bronx, NY
National Provider Identifier
1982649034
Registry record updated Dec 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X
License
216820 Issued in NY
Practice address
100 W Kingsbridge Rd
Medical Dept
Bronx, NY 10468-3961
Phone
(718) 410-1436
Fax
(718) 579-1192
NPI assigned
Jun 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Neuromusculoskeletal Medicine) Physician 204C00000X 216820 NY Primary

Addresses

Primary practice location

100 W Kingsbridge Rd
Medical Dept
Bronx, NY 10468-3961

Mailing address

100 W Kingsbridge Rd
Medical Dept
Bronx, NY 10468-3961
Phone (718) 410-1436

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
I20060703000043 NY Practitioner - Internal Medicine 9739191073 Reassigns benefits to 1 organization

National Provider Directory

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417478400000",
    "number": "1982649034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W KINGSBRIDGE RD",
            "address_2": "MEDICAL DEPT",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104683961",
            "telephone_number": "718-410-1436",
            "fax_number": "718-579-1192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W KINGSBRIDGE RD",
            "address_2": "MEDICAL DEPT",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104683961",
            "telephone_number": "718-410-1436",
            "fax_number": "718-579-1192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEWDU",
        "first_name": "WORKU",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2014-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "NY",
            "license": "216820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.