Individual provider Active NPI

Yidnekachew Tamiru Tadesse, M.D

  • Internal Medicine Physician
  • Zanesville, OH
National Provider Identifier
1992169189
Registry record updated Oct 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.135713 Issued in OH
Practice address
2951 Maple Ave
Zanesville, OH 43701
Phone
(740) 454-5880
NPI assigned
Apr 13, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2019

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 Physician 207R00000X 35.135713 OH Primary

Addresses

Primary practice location

2951 Maple Ave
Zanesville, OH 43701

Mailing address

2951 Maple Ave
Zanesville, OH 43701-1406
Phone (740) 454-5880

Other practice location 1

8900 Van Wyck Expy
Jamaica, NY 11418-2832
Phone (718) 206-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20190826001422 OH Practitioner - Internal Medicine 0345585667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Ohio Hospitalists, IncGroup PAC ID 7810985686, 194 clinicians

Practice addresses (Care Compare)

2951 Maple Ave
Zanesville, OH 43701-1406
Phone (740) 454-4000

2971 Maple Ave
Zanesville, OH 43701-1406
Phone (614) 255-6900

3535 Olentangy River Rd
Columbus, OH 43214-3908
Phone (614) 566-5000

Hospital & facility affiliations

  • Genesis Hospital Hospital, Zanesville, OH, CCN 360039
  • Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.135713OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ohio Hospitalists, Inc CurrentSince Oct 9, 2019 Accepting new patients
Genesis Healthcare System Past Accepting new patients
Medone Primary Care LLC PastSince Sep 27, 2024 Accepting new patients

Locations

3535 Olentangy River Rd
Columbus, OH 43214
Phone (614) 566-1997

3525 Olentangy River Rd
Ste 4330
Columbus, OH 43214
Phone (614) 255-6930

2951 Maple Ave
Zanesville, OH 43701
Phone (740) 454-4000

Organizations & group practices 3

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 6

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": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1992169189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2951 MAPLE AVE",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437011406",
            "telephone_number": "740-454-5880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2951 MAPLE AVE",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "43701",
            "telephone_number": "740-454-5880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8900 Van Wyck Expy",
            "address_purpose": "LOCATION",
            "city": "Jamaica",
            "state": "NY",
            "postal_code": "114182832",
            "country_code": "US",
            "telephone_number": "718-206-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TADESSE",
        "first_name": "YIDNEKACHEW",
        "middle_name": "TAMIRU",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-13",
        "last_updated": "2019-10-10",
        "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": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.135713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zanesville, OH

Sources for this page

Verify at the official NPI Registry.