Ginette C. Ayeni, FNP-BC
Individual provider Active NPI Family Nurse Practitioner · Glenview, IL
NPI 1811245681 · NPPES record last updated Jun 16, 2018
Key facts
- NPI
- 1811245681
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 209.009645 (IL)
- Practice address
- 2050 Claire CT
Glenview, IL 60025-7635 - Phone
- (847) 467-7423
- Fax
- (847) 556-1715
- NPI assigned
- Aug 27, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250226003843 | WI | Practitioner - Nurse Practitioner | 3274782941 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.009645 | IL | MD | Family Nurse Practitioner |
| 209009641 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carelon Medical Partners, PC | Current |
Accepting new patients |
Locations
12898 Towne Center Dr
Cerritos, CA 90703
Phone (800) 331-1476
12900 Park Plaza Dr
Ste 150
Cerritos, CA 90703
Phone (562) 622-2800
11414 W Park Pl
Ste 202
Milwaukee, WI 53224
Phone (414) 292-7060
Interoperability endpoints
- gayeni19742@carelonhealth.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209.009645 | IL | Yes |
Addresses
Primary practice location
2050 Claire CT
Glenview, IL 60025-7635
Mailing address
2050 Claire CT
Glenview, IL 60025-7635
Phone (847) 556-1707
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811245681 | Medicaid | IL |
Other providers in Glenview, IL
- Adrian Ferrer Atun
- Cindy Au
- Augusto Montalvo, MDSC
- Av Performance Therapy PLLC
- Alla Aver
- Ayur Soul Care Inc
- Ayzenshteyn Chiropractic
- Elham Azizi
- Martina Azizi
- Soya Babu
All providers in Glenview, IL · Family Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.