Individual provider Active NPI

Endalenesh Tsegaye Hailu, NP

  • Nurse Practitioner
  • Mountain View, CA
National Provider Identifier
1629788948
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95019237 Issued in CA
Practice address
701 E El Camino Real
Mountain View, CA 94040-2833
Phone
(650) 934-7500
NPI assigned
Nov 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95019237 CA Primary

Addresses

Primary practice location

701 E El Camino Real
Mountain View, CA 94040-2833

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20230105000498 CA Practitioner - Nurse Practitioner 2961872197 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
Telehealth
Offers telehealth services
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

15720 Winchester Blvd
Los Gatos, CA 95030-3337
Phone (408) 934-7000

370 Distel Cir
Los Altos, CA 94022-1404
Phone (650) 254-5200

701 E El Camino Real
Mountain View, CA 94040-2833
Phone (650) 691-6174

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
California PHS PC Nurse Practitioner CurrentSince Feb 22, 2023 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Jan 1, 2024 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Jan 1, 2024 Accepting new patients
J M Geiss DO Apc CurrentSince Dec 1, 2022 Accepting new patients
Sutter East Bay Medical Foundation Past Accepting new patients

Locations (25 of 28)

18400 US Highway 18
Apple Valley, CA 92307
Phone (760) 810-7590

350 John Muir Pkwy
Ste 160
Brentwood, CA 94513
Phone (925) 204-1920

1420 E Palomar St
Chula Vista, CA 91913

1950 University Ave
Ste 160
East Palo Alto, CA 94303
Phone (650) 317-8100

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

7638 N Ingram Ave
#111A
Fresno, CA 93711

1189 E Herndon Ave
Ste 103
Fresno, CA 93720
Phone (559) 450-7777

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

3415 S Sepulveda Blvd
Ste 1100
Los Angeles, CA 90034
Phone (424) 348-4558

15720 Winchester Blvd
Los Gatos, CA 95030
Phone (408) 730-6130

1900 Coffee Rd
Modesto, CA 95355
Phone (209) 491-0904

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

701 E El Camino Real
Mountain View, CA 94040
Phone (650) 404-8370

520 Superior Ave
Ste 255
Newport Beach, CA 92663
Phone (949) 720-9266

101 Rowland Way
Ste 220
Novato, CA 94945
Phone (415) 878-7200

2592 N Santiago Blvd
Orange, CA 92867
Phone (714) 577-2271

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

3550 Churn Creek Rd
Redding, CA 96002
Phone (530) 222-3630

1555 East St
Ste 200
Redding, CA 96001
Phone (530) 229-0911

151 N Sunrise Ave
Ste 1205
Roseville, CA 95661
Phone (916) 789-1505

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

5 Hutton Centre Dr
Ste 950
Santa Ana, CA 92707
Phone (855) 434-7663

28650 Newhall Ranch Rd
Santa Clarita, CA 91355
Phone (661) 347-0051

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • FHIR API: https://api.platform.athenahealth.com/19831/brand/2/csg/1/fhir/r4
  • Direct secure messaging: etsegayehailu674538@hisp.ehr.sutterhealth.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1669593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1629788948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E EL CAMINO REAL",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940402833",
            "telephone_number": "650-934-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSEGAYE HAILU",
        "first_name": "ENDALENESH",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-28",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95019237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain View, CA

Sources for this page

Verify at the official NPI Registry.