Berhanu Ejigu Kededa, NP-C - Medicare Nurse Practitioner in Tucker, GA

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Berhanu Ejigu Kededa, NP-C is a medicare enrolled "Nurse Practitioner - Family" in Tucker, Georgia. He graduated from nursing school in 2018 and has 8 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Post Acute Medical Pllc, Daiya Healthcare Pllc and his current practice location is 5576 Princeton Run Trl, Tucker, Georgia. You can reach out to his office (for appointments etc.) via phone at (678) 793-8808.

Berhanu Ejigu Kededa is licensed to practice in Georgia (license number RN152429) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1184994105.

Contact Information

Berhanu Ejigu Kededa, NP-C
5576 Princeton Run Trl,
Tucker, GA 30084-8463
(678) 793-8808
Not Available

Map and Direction




Provider's Profile

Full NameBerhanu Ejigu Kededa
GenderMale
SpecialityNurse Practitioner
Experience8 Years
Location5576 Princeton Run Trl, Tucker, Georgia
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Berhanu Ejigu Kededa graduated from nursing school in 2018
  NPI Data:
  • NPI Number: 1184994105
  • Provider Enumeration Date: 01/06/2012
  • Last Update Date: 10/09/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 5991957011
  • Enrollment ID: I20220713002031

Medical Identifiers

Medical identifiers for Berhanu Ejigu Kededa such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1184994105NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163WH0200XRegistered Nurse - Home Health 202205124RN (Oregon)Secondary
363LF0000XNurse Practitioner - Family RN152429 (Georgia)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Good Samaritan Society - Fairlawn VillageGresham, ORNursing home

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Post Acute Medical Pllc5193156115375
Daiya Healthcare Pllc600215861582

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. Berhanu Ejigu Kededa allows following entities to bill medicare on his behalf.
Entity NameDaiya Healthcare Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1477027381
PECOS PAC ID: 6002158615
Enrollment ID: O20200309000992
Entity NameImpact Physician Group Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1114428612
PECOS PAC ID: 6204199086
Enrollment ID: O20231222003031
Entity NameAltea Medical Oregon Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1184451254
PECOS PAC ID: 7315470895
Enrollment ID: O20241023002539
Entity NameMatthews Family Primary Care Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1629899448
PECOS PAC ID: 5890214340
Enrollment ID: O20250528001419

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. Berhanu Ejigu Kededa 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 AddressPractice Location Address
Berhanu Ejigu Kededa, NP-C
5576 Princeton Run Trl,
Tucker, GA 30084-8463

Ph: (678) 793-8808		Berhanu Ejigu Kededa, NP-C
5576 Princeton Run Trl,
Tucker, GA 30084-8463

Ph: (678) 793-8808

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.