Eliezer M Yachini, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2023210354 Issued in CA

Practice address

20046 Betz Dr
Winnetka, CA 91306-1107

Phone

(661) 916-5362

NPI assigned

Jun 3, 2024

Last updated

Jun 3, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lakeside Medical Organization a Medical Group IncGroup PAC ID 7618005166, 64 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eliezer.yachini.p1@direct.lakeside.nextgenshare.com

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

• Emet Nursing and Wound Care, a Professional Corporation

  • Family Nurse Practitioner
  • Northridge, CA
  • NPI 1043100381
  Medicare reassignment NPD Authorized official
• Lakeside Medical Organization, a Medical Group Inc.

  • Internal Medicine Physician
  • West Hills, CA
  • NPI 1831426642
  Medicare reassignment Care Compare group NPD
• Restore Mobile Wound Care

  • Family Medicine Physician
  • Woodland Hills, CA
  • NPI 1780417790
  Medicare reassignment NPD
• Wellness Mobile Clinic

  • General Practice Physician
  • Woodland Hills, CA
  • NPI 1376378810
  Medicare reassignment NPD

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1205677523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20046 BETZ DR",
            "city": "WINNETKA",
            "state": "CA",
            "postal_code": "913061107",
            "telephone_number": "661-916-5362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20046 BETZ DR",
            "city": "WINNETKA",
            "state": "CA",
            "postal_code": "913061107",
            "telephone_number": "661-916-5362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YACHINI",
        "first_name": "ELIEZER",
        "middle_name": "M",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "2023210354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wilbur Imaging Partners Inc (OZ Radiology)
• Willpower Wellness and Physical Therapy
• Winnetka Assisted Living Inc.
• Winnetka Home Care, Inc
• Winnetka Medical Group Inc (Health & Beauty Clinic)
• Justin Noel Yap, RPH
• Angelica Yerena
• Jittdaroon Yoobhat
• Young Memories Home Health Care
• Young Memories Hospice Care

• Family Nurse Practitioner in Winnetka, CA
• Providers in Winnetka, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.