EDEN ASEFAW GHEBRESILASIE (PA) – Physician Assistant, NPI 1164591400

EDEN ASEFAW GHEBRESILASIE (PA) is a healthcare provider. based in Miami beach, Florida. specializing in Physician Assistant. They hold the professional credentials PA. They hold a License No. PA3418 (FL). The NPI Number for EDEN ASEFAW GHEBRESILASIE (PA) is 1164591400

Main info

Female
Name
EDEN ASEFAW GHEBRESILASIE (PA)
NPI
1164591400
Phone
(305) 215-2929
Address
2642 COLLINS AVE
Enumeration Date
8 November 2006
Last Update Date
6 June 2008
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for EDEN ASEFAW GHEBRESILASIE (PA)

  • 2642, Collins Avenue, Miami Beach, Miami-Dade County, Florida, 33140, United States

    APT 207

    MIAMI BEACH, FL 33140

    Phone: (305) 215-2929

    Type: Mailing

  • 18260, Northeast 19th Avenue, North Miami Beach, Miami-Dade County, Florida, 33162, United States

    SUITE 201

    NORTH MIAMI BEACH, FL 331621632

    Phone: (305) 956-9062

    Fax: (305) 354-4524

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 41 Open Payments records for all available years, with a total value of $736.

Total Amount is formed as General ($736) + Research ($0) + Ownership ($0) = $736.

Last reported payment date: 2024-12-20 • Largest payer in this snapshot: PFIZER INC. ($181).

Total Amount

$736

General + Research + Ownership

Payments

41

Total payment records

General Amount

$736

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-20

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2013-08-05

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
I20130805000987IPhysician AssistantNCTBD

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 33140)

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Reviews

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Frequently asked questions

What identifier follows EDEN ASEFAW GHEBRESILASIE (PA) across health systems?
The NPI 1164591400 uniquely identifies EDEN ASEFAW GHEBRESILASIE (PA) in U.S. healthcare data.
Should I treat EDEN ASEFAW GHEBRESILASIE (PA) as an active provider?
Patients and plans typically see EDEN ASEFAW GHEBRESILASIE (PA) as active in the national extract.
What services align with EDEN ASEFAW GHEBRESILASIE (PA)'s listing?
EDEN ASEFAW GHEBRESILASIE (PA)'s public classification highlights Physician Assistant. Clinical services aligned with this taxonomy classification.
Which community is linked to EDEN ASEFAW GHEBRESILASIE (PA)?
EDEN ASEFAW GHEBRESILASIE (PA) shows a connection to Miami Beach, Florida in registry-derived data.
Can I export EDEN ASEFAW GHEBRESILASIE (PA)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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