Individual provider Active NPI

Yekaba K Ayelegne, FNP

  • Family Nurse Practitioner
  • Parker, CO
National Provider Identifier
1396251518
Registry record updated Nov 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0993431 Issued in CO
Practice address
12230 Lioness Way
Parker, CO 80134
Phone
(720) 644-9355
NPI assigned
Dec 26, 2017
Last updated
Nov 16, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2018

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 0993431 CO Primary

Addresses

Primary practice location

12230 Lioness Way
Parker, CO 80134

Mailing address

5023 W 120TH Ave Ste 312
Broomfield, CO 80020-5606
Phone (720) 644-9355

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20210107001215 WA Practitioner - Nurse Practitioner 7012277783 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fandm Healthcare, LLCGroup PAC ID 8628462983, 30 clinicians

Practice addresses (Care Compare)

Tacoma, WA 98406
Phone (253) 777-1423

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0993431COMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Post Acute Medical PLLC CurrentSince Mar 7, 2022 Accepting new patients
F&M Healthcare, LLC CurrentSince Oct 1, 2022 Accepting new patients

Locations

400 E Rivulon Blvd
Ste 103
Gilbert, AZ 85297

6220 S Alaska St
Tacoma, WA 98408
Phone (253) 473-2273

6824 19th St W
#256
University Place, WA 98466
Phone (253) 777-1423

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1514246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542326400000",
    "number": "1396251518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5023 W 120TH AVE STE 312",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800205606",
            "telephone_number": "720-644-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12230 LIONESS WAY",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "80134",
            "telephone_number": "720-644-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYELEGNE",
        "first_name": "YEKABA",
        "middle_name": "K",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-26",
        "last_updated": "2018-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "0993431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parker, CO

Sources for this page

Verify at the official NPI Registry.