Zeyerusalem Woldesilasse

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

NP95016910 Issued in CA

Practice address

10385 Old Placerville Rd
Sacramento, CA 95827-2506

Phone

(916) 448-1770

Fax

(916) 448-3015

NPI assigned

Sep 8, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northbay Health Medical FoundationGroup PAC ID 3274010871, 207 clinicians

Northbay Physicians Surgery Center, LLCGroup PAC ID 0042122244, 336 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

91.12 of 100Reported as group

Quality

66.76

Promoting interoperability

100

Improvement activities

40

Cost

70.33

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations (25 of 26)

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.

• Northbay Health Medical Foundation

  • Internal Medicine Physician
  • Fairfield, CA
  • NPI 1760283527
  Medicare reassignment Care Compare group NPD
• Northbay Healthcare Group

  • General Acute Care Hospital
  • Fairfield, CA
  • NPI 1821147786
  Medicare reassignment Care Compare group NPD
• All Inclusive Medical Services, Inc

  • Internal Medicine Physician
  • Carmichael, CA
  • NPI 1518369891
  Medicare reassignment NPD
• Chandan DS Cheema MD Inc

  • Internal Medicine Physician
  • Fair Oaks, CA
  • NPI 1598965667
  Medicare reassignment NPD
• Elk Grove Urgent Care Inc

  • Urgent Care Clinic/Center
  • Elk Grove, CA
  • NPI 1285812024
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment NPD
• Northbay Healthcare Group

  • Multi-Specialty Clinic/Center
  • Vacaville, CA
  • NPI 1760534713
  NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Richmond, CA
  • NPI 1235226531
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD

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

{
    "created_epoch": "1631059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1174292767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 NECTAR CIR",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957574333",
            "telephone_number": "602-570-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10385 OLD PLACERVILLE RD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272506",
            "telephone_number": "916-448-1770",
            "fax_number": "916-448-3015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLDESILASSE",
        "first_name": "ZEYERUSALEM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-08",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "NP95016910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP95016910",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Corttni Woehl
• Nichole C. Wofford, LMFT, MSW
• Lisa Wohlers, COTA
• Seghen Woldai
• Yohannes Woldegabriel, PHARMD
• Janeth Wolenik, OTR/L
• Amy Mikail Wolf, M.D.
• Gretchen Wolf, COTA
• Joan Collette Wolf, PHYSICIAN ASSISTANT
• Mary Elizabeth Wolf, R.N.

• Primary Care Nurse Practitioner in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; 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.