KERENGE AYUK AKO-EBOT – Psychiatric/Mental Health Nurse Practitioner, NPI 1790443075

KERENGE AYUK AKO-EBOT is a healthcare provider. based in White bear lake, Minnesota. specializing in NURSE PRACTITIONER. They hold a License No. 8588 (MN). The NPI Number for KERENGE AYUK AKO-EBOT is 1790443075

Main info

Female
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
KERENGE AYUK AKO-EBOT
NPI
1790443075
Phone
(651) 442-6406
Address
1675 HIGHWAY 96 E
Enumeration Date
3 December 2021
Last Update Date
28 October 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6128736963
Graduation Year
2021 (5 years ago)
PAC ID
5698168359
Group Practice PAC ID
4789684861
Professional Enrollment ID
I20220202001193
Address ID
MN554151623MI701XXAVEX300
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

5,720 NURSE PRACTITIONER in MN

Provider Addresses for KERENGE AYUK AKO-EBOT

  • 1675 HIGHWAY 96 E

    WHITE BEAR LAKE, MN 551103617

    Phone: (651) 442-6406

    Type: Location

  • 1675 Highway 96 E

    White Bear Lake, MN 551103617

    Phone: (651) 442-6406

    Type: Location

  • 701 PARK AVE

    MINNEAPOLIS, MN 554151623

    Phone: (612) 873-3000

    Type: Mailing

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: 2022-02-02

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
I20220202001193INurse PractitionerMNTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes9015$0
View full utilization report →

Insurance plans in this area (ZIP 55110)

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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: 4789684861View full group profile

Reviews

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Frequently asked questions

What is the 10-digit NPI for KERENGE AYUK AKO-EBOT?
KERENGE AYUK AKO-EBOT — NPI 1790443075 — is the standard way to identify this listing.
Is KERENGE AYUK AKO-EBOT listed as active for patients and plans?
The listing shows KERENGE AYUK AKO-EBOT as active in the NPI system.
What is KERENGE AYUK AKO-EBOT's primary classification?
Psychiatric/Mental Health Nurse Practitioner is the headline specialty for KERENGE AYUK AKO-EBOT here. Clinical services aligned with this taxonomy classification.
What area does KERENGE AYUK AKO-EBOT serve?
KERENGE AYUK AKO-EBOT's listing highlights White Bear Lake, Minnesota; more addresses can appear in NPPES.
Is the information about KERENGE AYUK AKO-EBOT up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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