Teshome Shikesso, NP PSYCH/MENTAL HEAL

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP61323848 Issued in WA

Practice address

3955 156TH St NE
Marysville, WA 98271-4831

Phone

(360) 651-6400

NPI assigned

Jan 22, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vest Seattle LLC 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Vest Seattle, LLC

  • Psychiatry Physician
  • Marysville, WA
  • NPI 1104338144

  Psychiatric/Mental Health, WA

  Medicare reassignment Care Compare group NPD
• Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Aberdeen, WA
  • NPI 1811051170

  WA

  Medicare reassignment NPD
• Vest Seattle, LLC

  • Psychiatric Hospital
  • Marysville, WA
  • NPI 1679020150
  Care Compare group
• Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Mount Vernon, WA
  • NPI 1023247541
  NPD
• Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Spanaway, WA
  • NPI 1922624642

  Registered Nurse

  NPD

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

{
    "created_epoch": "1548115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1124592357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6C W INTERCITY AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982042730",
            "telephone_number": "206-854-0329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3955 156TH ST NE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982714831",
            "telephone_number": "360-651-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIKESSO",
        "first_name": "TESHOME",
        "credential": "NP PSYCH/MENTAL HEAL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-22",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61323848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dan F Shaw, DMD
• Scott Gallagher Shaw, DDS
• Kassim Ibrahim Sheimo
• Triana B Sherwood, LMP
• Sophia Shiau, M.D.
• Jessica Shin
• Minkyung Shin, MD
• Paul F Shoup
• Denise Shushan, M.D.
• Arminder K Sidhu

• All providers in Marysville, WA
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.