Individual provider Active NPI

Lilyne Michele Mekoudjou Tchakonte, NURSE PRACTITONER

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1528736360
Registry record updated Aug 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11015069 Issued in FL
Practice address
10899 SW 4TH St Apt 601
Miami, FL 33174-4402
Phone
(404) 740-0112
NPI assigned
Sep 4, 2021
Last updated
Aug 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2023

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 11015069 FL Primary

Addresses

Primary practice location

10899 SW 4TH St Apt 601
Miami, FL 33174-4402

Mailing address

3838 N Campbell Ave
Tucson, AZ 85719-1454
Phone (404) 740-0112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220906002115 AZ Practitioner - Nurse Practitioner 6305220690 Reassigns benefits to 3 organizations
I20230912000003 FL Practitioner - Nurse Practitioner 6305220690

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner-University Medical GroupGroup PAC ID 7719899871, 1,066 clinicians

Practice addresses (Care Compare)

3838 N Campbell Ave
BLDG 1
Tucson, AZ 85719-1454
Phone (520) 694-2873

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.34 of 100Reported as apm
Quality
74.56
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11015069FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aleracare Aic LLC Nurse Practitioner CurrentSince Sep 26, 2023 Accepting new patients
Banner-University Medical Group Current Accepting new patients
Banner-University Medical Group CurrentSince Aug 2, 2022 Accepting new patients
Signify Health, LLC Nurse Practitioner CurrentSince Oct 1, 2023 Accepting new patients
Banner-University Medical Group CurrentSince Aug 2, 2022 Accepting new patients
Cloud Health Medical Group, P.a. Past Accepting new patients

Locations

2705 S Alma School Rd
Chandler, AZ 85286
Phone (480) 820-7246

930 N Switzer Canyon Dr
Ste 201
Flagstaff, AZ 86001
Phone (520) 542-2125

3555 Western Ave
Kingman, AZ 86409
Phone (928) 530-5430

5350 E High St
Ste 300
Phoenix, AZ 85054
Phone (480) 716-5820

3100 N Navajo Dr
Ste B3
Prescott Valley, AZ 86314
Phone (480) 716-3476

20185 E Ocotillo Rd
Ste 105
Queen Creek, AZ 85142
Phone (480) 677-3600

1625 N Campbell Ave
Tucson, AZ 85719

2120 W Ina Rd
Ste 100
Tucson, AZ 85741
Phone (520) 395-0471

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

3838 N Campbell Ave
Bldg 1
Tucson, AZ 85719
Phone (520) 694-2873

3838 N Campbell Ave
Bldg 2
Tucson, AZ 85719

535 N Wilmot Rd
Ste 101
Tucson, AZ 85711
Phone (520) 694-9988

6369 E Tanque Verde Rd
Ste 220
Tucson, AZ 85715
Phone (520) 298-8388

2110 W 24th St
Ste A
Yuma, AZ 85364
Phone (855) 442-7700

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 6

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 4

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": "1630713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1528736360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3838 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857191454",
            "telephone_number": "404-740-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10899 SW 4TH ST APT 601",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331744402",
            "telephone_number": "404-740-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEKOUDJOU TCHAKONTE",
        "first_name": "LILYNE MICHELE",
        "credential": "NURSE PRACTITONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-04",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11015069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.