Dr Aderajew Amsalu Taddesse, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Boston, Massachusetts. His current practice location is
15 Francis St, Boston, Massachusetts. You can reach out to his office (for appointments etc.) via phone at
(617) 732-7420.
Dr Aderajew Amsalu Taddesse is licensed to practice in Massachusetts (license number 291746) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1982068094.
Physician's Profile
Full Name | Dr Aderajew Amsalu Taddesse |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 15 Francis St, Boston, Massachusetts |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1982068094
- Provider Enumeration Date: 04/06/2016
- Last Update Date: 04/18/2023
Medicare PECOS Information:
- PECOS PAC ID: 7113228719
- Enrollment ID: I20190814003380
Medical Identifiers
Medical identifiers for Dr Aderajew Amsalu Taddesse such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1982068094 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207R00000X | Internal Medicine | 291746 (Massachusetts) | Secondary |
207RP1001X | Internal Medicine - Pulmonary Disease | 291746 (Massachusetts) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | 291746 (Massachusetts) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Aderajew Amsalu Taddesse allows following entities to bill medicare on his behalf.
Entity Name | Wellstar Medical Group, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1558664003 PECOS PAC ID: 6709065402 Enrollment ID: O20110127000374 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Aderajew Amsalu Taddesse is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Aderajew Amsalu Taddesse, MD 15 Francis St, Boston, MA 02115-6105 Ph: (617) 732-7420 | Dr Aderajew Amsalu Taddesse, MD 15 Francis St, Boston, MA 02115-6105 Ph: (617) 732-7420 |
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