HENOK BEREHANIE TESFAY – Internal Medicine Physician, NPI 1114667235

HENOK BEREHANIE TESFAY is a healthcare provider. based in Trinity, Florida. specializing in INTERNAL MEDICINE. They hold a License No. 35.153811 (OH). The NPI Number for HENOK BEREHANIE TESFAY is 1114667235

Main info

Male
Sole Proprietor
4 Years Of Experience
Accepts Medicare Assignment
Name
HENOK BEREHANIE TESFAY
NPI
1114667235
Phone
Not provided
Address
9330 STATE ROAD 54
Enumeration Date
29 March 2022
Last Update Date
15 August 2025

Doctor Profile

Medical School Name
HOWARD UNIVERSITY COLLEGE OF MEDICINE
Secondary Phone
7407797500
Graduation Year
2022 (4 years ago)
PAC ID
3173023793
Group Practice PAC ID
3173953460
Professional Enrollment ID
I20250826004511
Address ID
OH456019031CH272XXRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness85
Years active:4State licenses:1Digital endpointsOther names

12,368 INTERNAL MEDICINE in FL

Provider Addresses for HENOK BEREHANIE TESFAY

  • 9330 STATE ROAD 54

    TRINITY, FL 346551808

    Phone:

    Type: Mailing

  • 1498 PACIFIC AVE STE 500

    TACOMA, WA 984024210

    Phone: (855) 768-6363

    Type: Mailing

  • 272 HOSPITAL RD

    CHILLICOTHE, OH 456019031

    Phone: (740) 779-7500

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-08-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250826004511IInternal MedicineOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 34655)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3173953460View full group profile
NameSpecialtyState
-OH
Internal MedicineNV
Physician AssistantMI
Hospitalist, Internal MedicineNY
Internal MedicineOH
Nurse PractitionerOH
Internal MedicineOH
Nurse PractitionerOH
Internal MedicineAR
Internal Medicine, Geriatric MedicineMI

Reviews

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Frequently asked questions

Is there an official ID for HENOK BEREHANIE TESFAY in U.S. healthcare records?
The official identifier for HENOK BEREHANIE TESFAY is NPI 1114667235.
Active or inactive — what applies to HENOK BEREHANIE TESFAY?
You should see HENOK BEREHANIE TESFAY as active in CMS-hosted NPPES data.
What area of care is associated with HENOK BEREHANIE TESFAY?
HENOK BEREHANIE TESFAY's record emphasizes Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Is HENOK BEREHANIE TESFAY associated with Trinity?
Public fields place HENOK BEREHANIE TESFAY around Trinity, Florida. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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