NYAT FREWEYNI TEWOLDE (PA-C) – Physician Assistant, NPI 1043884117
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,223 PHYSICIAN ASSISTANT in NV
Provider Addresses for NYAT FREWEYNI TEWOLDE (PA-C)
PO BOX 100744
ATLANTA, GA 303840744
Phone:
Type: Mailing
3196 S MARYLAND PKWY STE 425
LAS VEGAS, NV 891092318
Phone: (725) 205-0725
Fax: (725) 204-5251
Type: Location
PO BOX 12357
AUGUSTA, GA 309142357
Phone: (706) 863-9595
Fax: (706) 868-8375
Type: Mailing
3186 S MARYLAND PKWY
LAS VEGAS, NV 891092317
Phone: (706) 863-9595
Fax: (706) 868-8375
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 6 Open Payments records for all available years, with a total value of $369.
Total Amount is formed as General ($369) + Research ($0) + Ownership ($0) = $369.
Last reported payment date: 2024-03-19 • Largest payer in this snapshot: Acera Surgical, Inc. ($298).
Total Amount
$369
General + Research + Ownership
Payments
6
Total payment records
General Amount
$369
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-03-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Acera Surgical, Inc. | $298 |
| KCI USA, Inc. | $40 |
| Integra LifeSciences Corporation | $16 |
| Smith+Nephew, Inc. | $16 |
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: 2021-07-01
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 |
|---|---|---|---|---|
| I20210701003101 | I | Physician Assistant | NV | 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 |
|---|---|---|---|---|
| 15002 | Preparation of skin graft site of trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less | 13 | 11 | $0 |
Insurance plans in this area (ZIP 30384)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | NV | |
| Internal Medicine, Cardiovascular Disease (Cardiology) | GA | |
| Cardiovascular Disease (Cardiology) | GA | |
| H E M A T O L O G Y/ O N C O L O G Y | CA | |
| Physical Medicine And Rehabilitation | NV | |
| Nurse Practitioner | NV | |
| Nurse Practitioner | NV | |
| Physician Assistant | GA | |
| Colorectal Surgery (Proctology) | NV | |
| Thoracic Surgery, Cardiac Surgery, Vascular Surgery | NV |
Reviews
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