Individual provider Active NPI

Joel K. Yerbo, APRN.CNP

  • Nurse Practitioner
  • Beaverton, OR
National Provider Identifier
1205162799
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
10025183 Issued in OR
Practice address
6800 SW 105TH Ave Ste 206
Beaverton, OR 97008-5487
Phone
(035) 430-1777
Fax
(503) 372-5119
NPI assigned
Oct 19, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN 353548 OH
Nurse Practitioner 363L00000X APRNCNP021726 OH
Nurse Practitioner 363L00000X 10025183 OR Primary

Addresses

Primary practice location

6800 SW 105TH Ave Ste 206
Beaverton, OR 97008-5487

Mailing address

6800 SW 105TH Ave Ste 206
Beaverton, OR 97008-5487
Phone (035) 430-1777

Other names 1

  • Eyual K Yerbo Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180320003488 OH Practitioner - Nurse Practitioner 6507093531 Reassigns benefits to 2 organizations
I20240902000152 OR Practitioner - Nurse Practitioner 6507093531 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CRM Physicians LLCGroup PAC ID 3678720729, 59 clinicians

Practice addresses (Care Compare)

6800 SW 105TH Ave
Beaverton, OR 97008-5468
Phone (503) 430-1777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN 353548OHMDRegistered Nurse
APRNCNP021726OHMDNurse Practitioner
10025183ORMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Restoration Home Health Care LLC Current Accepting new patients
Signify Health, LLC Nurse Practitioner CurrentSince Jun 15, 2023 Accepting new patients
CRM Physicians, LLC Nurse Practitioner CurrentSince Aug 1, 2024 Accepting new patients

Locations

175 S 3rd St
Ste 200
Columbus, OH 43215
Phone (267) 817-8902

6800 SW 105th Ave
Beaverton, OR 97008

6800 SW 105th Ave
Ste 206
Beaverton, OR 97008

650 SE Oak St
Hillsboro, OR 97123
Phone (503) 648-8588

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1255910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1205162799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 SW 105TH AVE STE 206",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970085487",
            "telephone_number": "035-430-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 SW 105TH AVE STE 206",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970085487",
            "telephone_number": "035-430-1777",
            "fax_number": "503-372-5119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YERBO",
        "first_name": "JOEL",
        "middle_name": "K.",
        "credential": "APRN.CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-19",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN 353548",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRNCNP021726",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "10025183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EYUAL",
            "last_name": "YERBO",
            "middle_name": "K",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Beaverton, OR

Sources for this page

Verify at the official NPI Registry.