Active NPI
Dereje G Lulu, NAC,
- In Home Supportive Care Agency
- Seattle, WA
National Provider Identifier
1336482280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- Practice address
- 14100 Linden Ave N
# 418
Seattle, WA 98133-7154 - Phone
- (206) 414-4710
- Fax
- (206) 494-7848
- NPI assigned
- Mar 28, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | Primary | ||
| Respite Care | 385H00000X | |||
| Home Health Agency | 251E00000X | IHS.FS.60405684 | WA |
Addresses
Primary practice location
14100 Linden Ave N
# 418
Seattle, WA 98133-7154
Mailing address
14100 Linden Ave N
# 418
Seattle, WA 98133-7154
Phone (206) 549-9648
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| IHS.FS.60405684 | Other | WA | WASHINGTON STATE HOME CARE AGENCE LICENSES PERMITSAND CERTIFICATES |
Other names 1
- Uthiopia In Home Care In Home Care
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IHS.FS.60405684 | WA | MD | Home Health Agency |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Utopia in Home Care Solution | Home Health | Current | Accepting new patients |
| Edmonds Garden Afh LLC | In Home Supportive Care | Current | Accepting new patients |
Organizations & group practices 2
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.
-
- Adult Day Care Clinic/Center
- Edmonds, WA
- NPI 1215669981
In Home Supportive Care
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423699200000",
"number": "1336482280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14100 LINDEN AVE N",
"address_2": "# 418",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981337154",
"telephone_number": "206-549-9648",
"fax_number": "206-494-7848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14100 LINDEN AVE N",
"address_2": "# 418",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981337154",
"telephone_number": "206-414-4710",
"fax_number": "206-494-7848"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LULU",
"first_name": "DEREJE",
"middle_name": "G",
"credential": "NAC,",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-03-28",
"last_updated": "2015-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": true
},
{
"code": "385H00000X",
"taxonomy_group": "",
"desc": "Respite Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "WA",
"license": "IHS.FS.60405684",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHINGTON STATE HOME CARE AGENCE LICENSES PERMITSAND CERTIFICATES",
"identifier": "IHS.FS.60405684",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "UTHIOPIA",
"last_name": "IN HOME CARE",
"middle_name": "IN HOME CARE",
"credential": "HOME CARE",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.