Dr Senayet Goitom, DNP is a medicare enrolled "Nurse Practitioner" physician in Excelsior, Minnesota. Her current practice location is
464 2nd St Ste 204, Excelsior, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(612) 787-8408.
Dr Senayet Goitom is licensed to practice in Minnesota (license number 12484) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1679387054.
Physician's Profile
| Full Name | Dr Senayet Goitom |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Location | 464 2nd St Ste 204, Excelsior, Minnesota |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1679387054
- Provider Enumeration Date: 02/05/2025
- Last Update Date: 04/27/2025
Medicare PECOS Information:
- PECOS PAC ID: 2062936982
- Enrollment ID: I20250411002093
Medical Identifiers
Medical identifiers for Dr Senayet Goitom such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1679387054 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208VP0000X | Pain Medicine - Pain Medicine | 12484 (Minnesota) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 12484 (Minnesota) | Secondary |
| 363L00000X | Nurse Practitioner | 12484 (Minnesota) | 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 Senayet Goitom allows following entities to bill medicare on her behalf.
| Entity Name | Rehabilitation Medicine Associates Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1093103145
PECOS PAC ID: 9335465558
Enrollment ID: O20150306000534 |
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| Entity Name | Healthfair Plus Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1376973461
PECOS PAC ID: 2365668720
Enrollment ID: O20220821000028 |
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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 Senayet Goitom 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 |
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Dr Senayet Goitom, DNP
8745 Davenport St Ne,
Blaine, MN 55449-4229
Ph: (612) 499-2098 | Dr Senayet Goitom, DNP
464 2nd St Ste 204,
Excelsior, MN 55331-2015
Ph: (612) 787-8408 |
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