Jerusalem Makonnen, RN,MSN,FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

8911 Issued in CA

Practice address

3850 Grand Ave
Oakland, CA 94610-1004

Phone

(510) 225-1013

NPI assigned

Aug 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

One Medical Group IncGroup PAC ID 2567623739, 330 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

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 and National Provider Directory roles.

• One Medical Group, Inc.

  dba One Medical Group

  • Family Medicine Physician
  • San Francisco, CA
  • NPI 1467781641
  Medicare reassignment Care Compare group NPD
• One Medical Group, Inc

  • Family Medicine Physician
  • Tigard, OR
  • NPI 1891521134
  NPD

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1972510022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 GRAND AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946101004",
            "telephone_number": "510-225-1013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKONNEN",
        "first_name": "JERUSALEM",
        "name_prefix": "Ms.",
        "credential": "RN,MSN,FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "8911",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "8911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ray Mak
• Kristinalisa Maka
• Sakirat Makanjuola
• Eve Serena Valerie Makdisi, PT
• Akinwunmi Kolade Makinde, DPT
• Andrea Makunje, MFT
• Yvette M Malamud Ozer, PHD
• Jennifer Tania Malarek, CRNA
• Cynthia Lara Malasky, ASW
• Malaya Acupuncture and Wellness Center

• Nurse Practitioner in Oakland, CA
• Providers in Oakland, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.