Gregory Imafidon, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP61288019 Issued in WA

Practice address

521 2ND PL N Ste 11-103
Kent, WA 98032-4537

Phone

(425) 690-3491

Fax

(425) 690-9091

NPI assigned

May 2, 2018

Last updated

Nov 18, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX, WA2 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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kittitas County Public Hospital Dist 1Group PAC ID 0547179608, 82 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kittitas Valley Home Health & Hospice Home health agency, Ellensburg, WA, CCN 507097
• Kittitas Valley Community Hospital Hospital, Ellensburg, WA, CCN 501333

Merit-based Incentive Payment System (MIPS)

Final score

98.34 of 100Reported as apm

Quality

89.25

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Kittitas County Public Hospital Dist 1

  dba Kittitas Valley Community Hospital

  • Critical Access Hospital
  • Ellensburg, WA
  • NPI 1356375307
  Medicare reassignment Care Compare group
• Valley Medical Group-Renton

  • General Acute Care Hospital
  • Renton, WA
  • NPI 1619209574

  Nurse Practitioner

  Medicare reassignment NPD
• Vida Y Salud-Health Systems Inc

  • Federally Qualified Health Center (FQHC)
  • Crystal City, TX
  • NPI 1770511032
  Medicare reassignment NPD
• Kittitas County Public Hosp Dist 1

  dba KVH Urology

  • Urology Physician
  • Ellensburg, WA
  • NPI 1437029832
  NPD
• Kittitas County Public Hospital Dist 1

  dba KVH Orthopedics

  • Specialist
  • Ellensburg, WA
  • NPI 1003016825
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kittitas County Public Hospital Dist 1

  dba Kittitas Valley Community Hospital

  • Critical Access Hospital
  • Ellensburg, WA
  • NPI 1356375307
  Care Compare affiliation
• Kittitas County Public Hospital Dist 1

  • Home Health Agency
  • Ellensburg, WA
  • NPI 1376561654
  Care Compare affiliation

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

{
    "created_epoch": "1525219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1811486228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 2ND PL N STE 11-103",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980324537",
            "telephone_number": "425-690-3491",
            "fax_number": "425-690-9091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 2ND PL N STE 11-103",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980324537",
            "telephone_number": "425-690-3491",
            "fax_number": "425-690-9091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "308 S Cesar Chavez Ave",
            "address_purpose": "LOCATION",
            "city": "Crystal City",
            "state": "TX",
            "postal_code": "788394200",
            "country_code": "US",
            "telephone_number": "830-374-2301",
            "fax_number": "830-374-9368",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4945 Las Lomas Dr",
            "address_purpose": "LOCATION",
            "city": "Mesquite",
            "state": "TX",
            "postal_code": "751503180",
            "country_code": "US",
            "telephone_number": "469-434-9784",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IMAFIDON",
        "first_name": "GREGORY",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-02",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61288019",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP137759",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "F04180510",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61288019",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP CERTIFICATION",
            "identifier": "F04180510",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "AP137759",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hibaq A Ibrahim, RN
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• Mildred Ikeya
• Abigail Carissa Ilar-Corpuz
• Image Family Dental, LLC
• Marc Alan Imlay, D.C. AND LAC.
• Steven Tatsuo Inaba, DDS
• Infinity Chiropractic
• Wanjiru N Iraki

• Nurse Practitioner in Kent, WA
• Providers in Kent, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.