Birhanu Z. Admassie, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95009185 Issued in CA

Practice address

2122 W Kettleman LN
Lodi, CA 95242

Phone

(209) 224-8517

NPI assigned

Oct 5, 2018

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

California Urgent Care Center Professional Corporation 3 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.

• California Urgent Care Center Professional Corporation

  • Urgent Care Clinic/Center
  • Stockton, CA
  • NPI 1588959084

  CA

  Medicare reassignment Care Compare group NPD
• Mercy West Urgent Care Inc

  • Emergency Medicine Physician
  • Turlock, CA
  • NPI 1356791099
  NPD (past)

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

{
    "created_epoch": "1538697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538697600000",
    "number": "1346715307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4059 LOST CANYON COURT, HOUSE",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "94531",
            "telephone_number": "925-779-1982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2122 W KETTLEMAN LN",
            "city": "LODI",
            "state": "CA",
            "postal_code": "95242",
            "telephone_number": "209-224-8517"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4059 lost canyon court",
            "address_2": "house",
            "address_purpose": "LOCATION",
            "city": "Antioch",
            "state": "CA",
            "postal_code": "945319453",
            "country_code": "US",
            "telephone_number": "925-779-1982",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2122 W Kettleman Ln",
            "address_purpose": "LOCATION",
            "city": "Lodi",
            "state": "CA",
            "postal_code": "95242",
            "country_code": "US",
            "telephone_number": "209-224-8517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADMASSIE",
        "first_name": "BIRHANU",
        "middle_name": "Z.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-05",
        "last_updated": "2018-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95009185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bobbie Renee Ables-Smith, LEP #3049
• Lucia Yolanda Acosta
• Tryphena P Adams
• Adils Non-Emergency Transport LLC
• Gladys B Adjei
• Victoria Secret Admire
• Adventist Health Physicians Network
• Adventist Health Physicians Network
• Adventist Health Physicians Network
• Adventist Health Physicians Network

• All providers in Lodi, CA
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2018; 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.