Feyissa Jafar Wagesso
Physician β’ Maplewood, MN
2468 Brenner Ave E
Maplewood, MN 551091573
This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.
Practice Location & Contact Primary Location
2468 Brenner Ave E
Maplewood, MN 551091573
What Public CMS Data Show
Physician: NPPES taxonomy is a reported classification, not proof of board certification.
NPI first issued
2024
The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.
What this does not show: NPI first issued
NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.
Source: CMS NPPES NPI Registry.
Medicare assignment not listed
CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.
Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.
Source: CMS Doctors and Clinicians, CMS release of October 2, 2026; Medicare.gov, βDoes your provider accept Medicare as full payment?β
No telehealth indicator
CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.
Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians, CMS release of October 2, 2026.
Sources: CMS Doctors and Clinicians, CMS release of October 2, 2026, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.
Text: T-MedInfo Β· Report an error.
Specialties & License Numbers Reported to NPPES
Self-certified to NPPES: 2025-08-08NUCC Taxonomy Code: 310400000X
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
NUCC Taxonomy Code: 3104A0630X
A facility providing supportive services to individuals who can function independently in most areas of activity, but exhibit abnormal behavioral responses and habits and therefore need special guidance, assistance and/or monitoring to assure safety and well being. This type of facility requires a staff with special training in dealing with and redirecting negative, violent or destructive behaviors.
Additional State Medicaid & Healthcare Payer Identifiers
Career & Practice History Timeline
Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status
Assisted Living Facility
NPI status registered as active in NPPES database
Registered at 2468 BRENNER AVE E, MAPLEWOOD, MN 551091573 (Tel: 7639107300)
Registered at 2468 BRENNER AVE E, MAPLEWOOD, MN 551091573 (Tel: 7639107300)
Recorded as FEYISSA WAGESSO
Assisted Living Facility
First registered as active Individual Practitioner in NPPES Database.
NPI Administrative Meta
Mailing Address
2468 Brenner Ave E
Maplewood, MN 551091573
Phone: 7639107300