Nyat Freweyni Tewolde, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2421 Issued in NV

Practice address

3196 S Maryland Pkwy Ste 425
Las Vegas, NV 89109-2318

Phone

(725) 205-0725

Fax

(725) 204-5251

NPI assigned

May 13, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Niyat Okbu Teweldebrhan Former name

Medicare fee-for-service enrollment

Enrolled in NV

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sunrise Mountainview Multispecialty Clinics LLCGroup PAC ID 1759469711, 64 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sunrise Hospital and Medical Center Hospital, Las Vegas, NV, CCN 290003

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: nyat.tewolde@hca3.eclinicaldirectplus.com

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.

• Sunrise Mountainview Multispecialty Clinics, LLC

  • Neurology Physician
  • Las Vegas, NV
  • NPI 1043402522
  Medicare reassignment Care Compare group

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

• Sunrise Hospital and Medical Center, LLC

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1861439952
  Care Compare affiliation

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

{
    "created_epoch": "1620864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672185600000",
    "number": "1043884117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100744",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303840744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3196 S MARYLAND PKWY STE 425",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891092318",
            "telephone_number": "725-205-0725",
            "fax_number": "725-204-5251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEWOLDE",
        "first_name": "NYAT",
        "middle_name": "FREWEYNI",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-13",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA2421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NIYAT",
            "last_name": "TEWELDEBRHAN",
            "middle_name": "OKBU",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Edgar Tevalan Sr.
• Deborah Dupont Teves
• Vishala Tewari
• Betiel Efrem Tewelde
• Candie Tewksbury
• Solomon Girmay Tewolde
• Josefina M Teylan
• TFC Behavioral Health
• TFK Wellness LLC
• Allen Bradford Thach, MD

• Physician Assistant in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.