Individual provider Active NPI

Yoely B Jaramillo

  • Nurse Practitioner
  • Moline, IL
National Provider Identifier
1629720891
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209024720 Issued in IL
Practice address
3900 28TH Avenue Dr
Moline, IL 61265-5536
Phone
(309) 281-6000
NPI assigned
Jan 19, 2022
Last updated
Feb 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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 A167102 IA
Nurse Practitioner 363L00000X 209024720 IL Primary

Addresses

Primary practice location

3900 28TH Avenue Dr
Moline, IL 61265-5536

Mailing address

3900 28TH Avenue Dr
Moline, IL 61265-5536
Phone (309) 721-0307

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jaramilloy@genesishealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 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
I20231031001450 IL Practitioner - Nurse Practitioner 2961858758 Reassigns benefits to 2 organizations
I20231109000619 IA Practitioner - Nurse Practitioner 2961858758 Reassigns benefits to 1 organization

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
Genesis Health SystemGroup PAC ID 7214841436, 217 clinicians

Practice addresses (Care Compare)

202 Picard St
Alpha, IL 61413-5023
Phone (309) 629-4601

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A167102IAMDNurse Practitioner
209024720ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Health System CurrentSince Dec 11, 2023 Accepting new patients
Genesis Health System Current Accepting new patients
Genesis Health System CurrentSince Dec 11, 2023 Accepting new patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Sep 19, 2023 Accepting new patients
Genesis Health System Past Accepting new patients

Locations

1227 E Rusholme St
Davenport, IA 52803
Phone (563) 324-8160

1351 W Central Park Ave
Ste 4100
Davenport, IA 52804
Phone (563) 355-9191

400 E Court Ave
Ste 110
Des Moines, IA 50309

202 Picard St
Alpha, IL 61413
Phone (309) 629-4601

306 46th Ave
East Moline, IL 61244
Phone (309) 796-2329

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

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7420

Organizations & group practices 5

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 1

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": "1642550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1629720891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 28TH AVENUE DR",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612655536",
            "telephone_number": "309-721-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 28TH AVENUE DR",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612655536",
            "telephone_number": "309-281-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARAMILLO",
        "first_name": "YOELY",
        "middle_name": "B",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-19",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A167102",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209024720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jaramilloy@genesishealth.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3900 28th Avenue Dr",
            "city": "Moline",
            "state": "IL",
            "country_code": "US",
            "postal_code": "612655536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Moline, IL

Sources for this page

Verify at the official NPI Registry.