Individual provider Active NPI

Julie Vellakkotte Yohannan, FNP

  • Family Nurse Practitioner
  • Sacaton, AZ
National Provider Identifier
1518405687
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP9873 Issued in AZ
Practice address
483 W Seed Farm Rd
Sacaton, AZ 85147-5000
Phone
(602) 528-1200
Fax
(602) 528-1255
NPI assigned
Feb 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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 AP9873 AZ Primary
Primary Care Nurse Practitioner 363LP2300X AP9873 AZ

Addresses

Primary practice location

483 W Seed Farm Rd
Sacaton, AZ 85147-5000

Mailing address

PO Box 38
Sacaton, AZ 85147-0001
Phone (602) 528-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20180417001795 TX Practitioner - Nurse Practitioner 1850677238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

483 W Seed Farm Rd
Hu Hu Kam Memorial Hosp
Sacaton, AZ 85147-0038
Phone (602) 528-1200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.21 of 100Reported as group
Quality
76.88
Promoting interoperability
76
Improvement activities
40
Cost
73.83

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP9873AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gila River Health Care CurrentSince Jun 26, 2018 Accepting new patients
Gila River Health Care Corporation CurrentSince Jun 26, 2018 Accepting new patients
Gila River Health Care Corporation Current Accepting new patients
Phoenix Neurological Institute, Inc CurrentSince Jul 1, 2017 Accepting new patients

Locations

1545 W Broadway Ave
Ste 101
Apache Junction, AZ 85120

1343 N Alma School Rd
Ste 205
Chandler, AZ 85224
Phone (480) 722-2588

1343 N Alma School Rd
Ste 160
Chandler, AZ 85224
Phone (480) 444-7447

875 N Greenfield Rd
Ste 105
Gilbert, AZ 85234
Phone (480) 897-2727

17487 S Healthcare Dr
#H
Laveen, AZ 85339
Phone (520) 550-6000

48203 W Farrell Rd
#H
Maricopa, AZ 85139
Phone (520) 568-3881

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1486512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1518405687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 38",
            "city": "SACATON",
            "state": "AZ",
            "postal_code": "851470001",
            "telephone_number": "602-528-1200",
            "fax_number": "602-528-1255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 W SEED FARM RD",
            "city": "SACATON",
            "state": "AZ",
            "postal_code": "851475000",
            "telephone_number": "602-528-1200",
            "fax_number": "602-528-1255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOHANNAN",
        "first_name": "JULIE",
        "middle_name": "VELLAKKOTTE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-08",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP9873",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AZ",
            "license": "AP9873",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacaton, AZ

Sources for this page

Verify at the official NPI Registry.