NPIMap

Individual provider Active NPI

Sebhatu Tewolde Gebrezgi, MD

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1982750360
Registry record updated Mar 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
196278 Issued in NY
Practice address
9408 Flatlands Ave
Brooklyn, NY 11236
Phone
(718) 272-0977
Fax
(718) 272-1088
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 196278 NY Primary
Legal Medicine 173000000X 196278 NY

Addresses

Primary practice location

9408 Flatlands Ave
Brooklyn, NY 11236

Mailing address

9408 Flatlands Ave
Brooklyn, NY 11236
Phone (718) 272-0977

Other identifiers 1

IdentifierTypeStateIssuer
01545362MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040918000085 NY Practitioner - Internal Medicine 6800864778 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interfaith Professional Physician Services PCGroup PAC ID 9931378171, 383 clinicians
Blue Nile Medical PLLCGroup PAC ID 6204196462, 2 clinicians

Practice addresses (Care Compare)

1 Brookdale PLZ
Brooklyn, NY 11212-3198

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

9408 Flatlands Ave
Brooklyn, NY 11236-3742
Phone (718) 272-0977

Hospital & facility affiliations

  • Girling Health Care of New York Home health agency, Brooklyn, NY, CCN 337243
  • Brookdale Hospital Medical Center Hospital, Brooklyn, NY, CCN 330233

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
196278NYMDLegal Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Brookdale Hospital Medical Center CurrentSince Jul 1, 1994 Accepting new patients
Blue Nile Medical PLLC Legal Medicine CurrentSince Dec 4, 2017 Accepting new patients
Interfaith Professional Physician Services, P.C. Internal Medicine CurrentSince Nov 26, 2023 Accepting new patients
The Brookdale Hospital Medical Center CurrentSince Jul 1, 1994 Accepting new patients
The Brookdale Hospital Medical Center Past Accepting new patients
Brookdale Hospital Medical Center Past Accepting new patients

Locations

9408 Flatlands Ave
Brooklyn, NY 11236
Phone (718) 212-0977

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

9408 Flatlands Ave
Ste 1
Brooklyn, NY 11236

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

9408 Flatlands Ave
Ste 2
Brooklyn, NY 11236

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

Networks

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

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331942400000",
    "number": "1982750360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9408 FLATLANDS AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11236",
            "telephone_number": "718-272-0977",
            "fax_number": "718-272-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9408 FLATLANDS AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11236",
            "telephone_number": "718-272-0977",
            "fax_number": "718-272-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEBREZGI",
        "first_name": "SEBHATU",
        "middle_name": "TEWOLDE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2012-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "196278",
            "primary": true
        },
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "NY",
            "license": "196278",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01545362",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.