Individual provider Active NPI

Yordanos Haile Tesfaye, PA-C

  • Physician Assistant
  • Temple, TX
National Provider Identifier
1023577418
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA12725 Issued in TX
Practice address
2401 S 31St St
Temple, TX 76508-2915
Phone
(254) 724-2111
NPI assigned
Mar 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA12725 TX Primary

Addresses

Primary practice location

2401 S 31St St
Temple, TX 76508-2915

Mailing address

PO Box 844658
Dallas, TX 75284-4658

Other practice location 1

1801 S 5th St Ste 130
McAllen, TX 78503-2915
Phone (956) 362-8340

Other practice location 2

5501 S McColl Rd
Edinburg, TX 78539-5503
Phone (956) 362-8677

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ytesfaye1053658@direct.sw.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190516000881 TX Practitioner - Physician Assistant 5799028684 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

1605 S 31St St
Baylor Scott and White Center for Dia
Temple, TX 76508-0001
Phone (254) 215-0100

1701 E Pflugerville Pkwy
Baylor Scott and White Clinic Pflug
Pflugerville, TX 78660-8990
Phone (512) 259-6000

239 W Business
190 Baylor Scott and White Clinic Coppe
Copperas Cove, TX 76522-2912
Phone (254) 542-9000

2401 S 31 St
Temple, TX 76508-0001
Phone (254) 724-2459

2401 S 31St St BLDG
35 Baylor Scott and White Roney Bone and
Temple, TX 76508-0001
Phone (254) 724-2663

5245 W Hwy 290
Baylor Scott and White Medical Center Austi
Austin, TX 78735-8963
Phone (512) 654-2100

5251 W Hwy 290
Baylor Scott and White Clinic Austin Oak Hi
Austin, TX 78735-8963
Phone (512) 654-3000

5251 W Hwy 290 100
Baylor Scott and White Cancer and Infusion Ce
Austin, TX 78735-8963
Phone (512) 654-4319

7451 W State Hwy 29
Baylor Scott and White Clinic Georg
Georgetown, TX 78628-6849
Phone (512) 509-8700

810 W U Ave
Temple, TX 76508-0001
Phone (254) 724-2585

Hospital & facility affiliations

  • Baylor Scott & White Medical Center - Temple Hospital, Temple, TX, CCN 450054

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic CurrentSince Mar 27, 2022 Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients

Locations

1701 E Pflugerville Pkwy
Pflugerville, TX 78660
Phone (512) 259-6000

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

2401 S 31st St
#200
Temple, TX 76508
Phone (254) 215-0100

Interoperability endpoints

  • Direct secure messaging: ytesfaye1053658@direct.sw.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1552608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1023577418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 S 31ST ST",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765082915",
            "telephone_number": "254-724-2111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 S 5th St Ste 130",
            "address_purpose": "LOCATION",
            "city": "McAllen",
            "state": "TX",
            "postal_code": "785032915",
            "country_code": "US",
            "telephone_number": "956-362-8340",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5501 S McColl Rd",
            "address_purpose": "LOCATION",
            "city": "Edinburg",
            "state": "TX",
            "postal_code": "785395503",
            "country_code": "US",
            "telephone_number": "956-362-8677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TESFAYE",
        "first_name": "YORDANOS",
        "middle_name": "HAILE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-15",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA12725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ytesfaye1053658@direct.sw.org",
            "affiliation": "N",
            "address_1": "2401 S 31st St",
            "city": "Temple",
            "state": "TX",
            "country_code": "US",
            "postal_code": "765082915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

Verify at the official NPI Registry.