Individual provider Active NPI

Michael Yeboah, FNP-BC

  • Family Nurse Practitioner
  • Sacramento, CA
National Provider Identifier
1285253559
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95014404 Issued in CA
Practice address
3701 J St Ste 201
Sacramento, CA 95816-5542
Phone
(916) 454-2345
NPI assigned
Apr 15, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95014404 CA Primary

Addresses

Primary practice location

3701 J St Ste 201
Sacramento, CA 95816-5542

Mailing address

8233 E Stockton Blvd Ste D
Sacramento, CA 95828-8203
Phone (916) 737-5555

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200619001418 CA Practitioner - Nurse Practitioner 1254753221 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95014404CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Elica Health Centers Current Accepting new patients
Wellspace Health CurrentSince Jun 22, 2020 Accepting new patients
Elica Health Centers CurrentSince Jan 11, 2024 Accepting new patients
Elica Health Centers CurrentSince Jan 11, 2024 Accepting new patients
Wellspace Health CurrentSince Jun 22, 2020 Accepting new patients
Wellspace Health Current Accepting new patients

Locations

8233 E Stockton Blvd
Ste D
Sacramento, CA 95828
Phone (916) 236-4700

1820 J St
Sacramento, CA 95811
Phone (916) 550-5481

777 12th St
Ste 250
Sacramento, CA 95814
Phone (916) 469-4690

1750 Wright St
Ste 1
Sacramento, CA 95825

1860 Howe Ave
Ste 440
Sacramento, CA 95825

3701 J St
Ste 201
Sacramento, CA 95816

155 15th St
Ste A
West Sacramento, CA 95691
Phone (916) 375-8981

1276 Halyard Dr
West Sacramento, CA 95691

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15691/brand/4/csg/1/fhir/r4

Organizations & group practices 6

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": "1586908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1285253559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8233 E STOCKTON BLVD STE D",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958288203",
            "telephone_number": "916-737-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 J ST STE 201",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165542",
            "telephone_number": "916-454-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEBOAH",
        "first_name": "MICHAEL",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-15",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95014404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.