Tiyamike Ezala, NP

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

53-80288-091 Issued in KS

Practice address

26061 W 150TH St
Olathe, KS 66061-8511

Phone

(913) 292-4410

NPI assigned

Jul 7, 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

Medicare fee-for-service enrollment

Enrolled in KS

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

Wound Care Plus LLCGroup PAC ID 6709175912, 43 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Wound Care Plus, LLC

  • Specialist
  • Saint Louis, MO
  • NPI 1841657053

  KS

  Medicare reassignment Care Compare group NPD
• Quality Wound Care LLC

  • Nurse Practitioner
  • Overland Park, KS
  • NPI 1497503452
  NPD Authorized official

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

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1255902623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26061 W 150TH ST",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660618511",
            "telephone_number": "913-292-4410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26061 W 150TH ST",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660618511",
            "telephone_number": "913-292-4410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZALA",
        "first_name": "TIYAMIKE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-07",
        "last_updated": "2021-07-07",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "53-80288-091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eye Associates of South Olathe
• Eye Care, LLC (Discover Vision Centers)
• Eye-Pros of Olathe Inc.
• Eyemart Express LLC
• Jennifer Thompson Eyler, M.D.
• Douglas W Fain, DDS.,MD
• Christopher Fairleigh, M.S. SLP
• Tyler Falck, LMLP
• Fales Pediatric Dentistry
• John Thomas Fales Jr., D.D.S., M.S.

• Family Medicine Physician in Olathe, KS
• Providers in Olathe, KS by specialty
• Family Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.