TIYAMIKE EZALA (NP) – Family Medicine Physician, NPI 1255902623

TIYAMIKE EZALA (NP) is a healthcare provider. based in Olathe, Kansas. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 53-80288-091 (KS). The NPI Number for TIYAMIKE EZALA (NP) is 1255902623

Main info

Female
Sole Proprietor
6 Years Of Experience
Accepts Medicare Assignment
Name
TIYAMIKE EZALA (NP)
NPI
1255902623
Phone
(913) 292-4410
Address
26061 W 150TH ST
Enumeration Date
7 July 2021
Last Update Date
7 July 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8882563814
Graduation Year
2020 (6 years ago)
PAC ID
5698114072
Group Practice PAC ID
6709175912
Professional Enrollment ID
I20240805003661
Address ID
KS674491662HE2XXXXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

3,551 NURSE PRACTITIONER in KS

Provider Addresses for TIYAMIKE EZALA (NP)

  • 26061 W 150TH ST

    OLATHE, KS 660618511

    Phone: (913) 292-4410

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $61.

Total Amount is formed as General ($61) + Research ($0) + Ownership ($0) = $61.

Last reported payment date: 2024-07-17 • Largest payer in this snapshot: Organogenesis Inc. ($23).

Total Amount

$61

General + Research + Ownership

Payments

3

Total payment records

General Amount

$61

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-07-17

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2024-08-05

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240805003661INurse PractitionerKSTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 66061)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6709175912View full group profile

Reviews

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Frequently asked questions

Can I use this page to confirm TIYAMIKE EZALA (NP)'s NPI?
Yes. TIYAMIKE EZALA (NP) is listed with NPI 1255902623 in the public NPI dataset.
Is TIYAMIKE EZALA (NP) listed as active for patients and plans?
The listing shows TIYAMIKE EZALA (NP) as active in the NPI system.
What taxonomy line describes TIYAMIKE EZALA (NP)?
For research purposes, treat TIYAMIKE EZALA (NP) as Family Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for TIYAMIKE EZALA (NP)?
TIYAMIKE EZALA (NP)'s geographic hint is Olathe, Kansas in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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