Individual provider Active NPI

Dawit Sahle

  • Family Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1396523064
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
301404 Issued in AZ
Practice address
1847 W Heatherbrae Dr
Phoenix, AZ 85015-4764
Phone
(602) 274-2100
Fax
(602) 535-3166
NPI assigned
Sep 15, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN165963 AZ
Family Nurse Practitioner 363LF0000X 301404 AZ Primary

Addresses

Primary practice location

1847 W Heatherbrae Dr
Phoenix, AZ 85015-4764

Mailing address

3283 S Miller Dr
Chandler, AZ 85286-0178
Phone (602) 410-4215

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20240423002722 AZ Practitioner - Nurse Practitioner 1951740976 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Epangelia Properties, LLC CurrentSince Apr 3, 2024 Accepting new patients

Locations

1847 W Heatherbrae Dr
Phoenix, AZ 85015
Phone (602) 249-4508

Organizations & group practices 1

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": "1694736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1396523064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3283 S MILLER DR",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852860178",
            "telephone_number": "602-410-4215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1847 W HEATHERBRAE DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850154764",
            "telephone_number": "602-274-2100",
            "fax_number": "602-535-3166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAHLE",
        "first_name": "DAWIT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-15",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RN165963",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "301404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.