Individual provider Active NPI

Doralia Yanely Flores, FNP

  • Nurse Practitioner
  • Fremont, NE
National Provider Identifier
1629676044
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
113720 Issued in NE
Practice address
410 E 22ND St Ste 1
Fremont, NE 68025-2640
Phone
(402) 727-7979
Fax
(402) 727-9306
NPI assigned
Oct 16, 2020
Last updated
Sep 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 113720 NE Primary
Family Medicine Physician 207Q00000X AP142984 TX

Addresses

Primary practice location

410 E 22ND St Ste 1
Fremont, NE 68025-2640

Mailing address

410 E 22ND St Ste 100
Fremont, NE 68025-2639
Phone (402) 727-7979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, TX2 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
I20221004000232 NE Practitioner - Nurse Practitioner 6709262470 Reassigns benefits to 1 organization
I20241210001589 TX Practitioner - Nurse Practitioner 6709262470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Siller Dermatology and Dermatologic Surgery PLLCGroup PAC ID 9638604671, 2 clinicians

Practice addresses (Care Compare)

4937 S Jackson Rd
Edinburg, TX 78539-7228
Phone (956) 230-6801

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
113720NEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Skin PC CurrentSince Aug 29, 2022 Accepting new patients
Siller Dermatology & Dermatologic Surgery PLLC CurrentSince Nov 1, 2024 Accepting new patients
Skin PC CurrentSince Aug 29, 2022 Accepting new patients
Allergy, Asthma & Immunology Associates P.C. PastSince Sep 11, 2022 Accepting new patients

Locations

1408 Veterans Dr
Ste 100
Elkhorn, NE 68022
Phone (402) 916-5664

410 E 22nd St
Ste 1
Fremont, NE 68025
Phone (402) 719-7152

4937 S Jackson Rd
Edinburg, TX 78539
Phone (956) 230-6801

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.

NPI Registry JSON

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

{
    "created_epoch": "1602806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1629676044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 E 22ND ST STE 100",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252639",
            "telephone_number": "402-727-7979",
            "fax_number": "402-727-9306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 E 22ND ST STE 1",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252640",
            "telephone_number": "402-727-7979",
            "fax_number": "402-727-9306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORES",
        "first_name": "DORALIA",
        "middle_name": "YANELY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-16",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "113720",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "AP142984",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, NE

Sources for this page

Verify at the official NPI Registry.