ZEYERUSALEM WOLDESILASSE – Primary Care Nurse Practitioner, NPI 1174292767
Primary Care Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
16,360 NURSE PRACTITIONER in CA
Provider Addresses for ZEYERUSALEM WOLDESILASSE
5201 NECTAR CIR
ELK GROVE, CA 957574333
Phone: (602) 570-4281
Type: Mailing
10385 OLD PLACERVILLE RD
SACRAMENTO, CA 958272506
Phone: (916) 448-1770
Fax: (916) 448-3015
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-01-19
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20220119000297 | I | Nurse Practitioner | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 11043 | Removal of muscle and/or tissue, 20.0 sq cm or less | 33 | 14 | $0 |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes | 21 | 14 | $0 |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 20 | 16 | $0 |
Insurance plans in this area (ZIP 95757)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | CA | |
| Physician Assistant | FL | |
| Physician Assistant | FL | |
| Physician Assistant | CA | |
| Physician Assistant | CA | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | CA | |
| General Practice | IL | |
| Physician Assistant | CA | |
| Physician Assistant | CA |
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