HIWOT WOLDGEORGIS – Nurse Practitioner, NPI 1265856215

HIWOT WOLDGEORGIS is a healthcare provider. based in Hazelwood, Missouri. specializing in NURSE PRACTITIONER. They hold a License No. 2013005895 (MO). The NPI Number for HIWOT WOLDGEORGIS is 1265856215

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
HIWOT WOLDGEORGIS
NPI
1265856215
Phone
Not provided
Address
1634 HURSTBOROUGH MANOR DR
Enumeration Date
11 February 2014
Last Update Date
5 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3147391333
Graduation Year
2012 (14 years ago)
PAC ID
2860622354
Group Practice PAC ID
9133123102
Professional Enrollment ID
I20140301000041
Address ID
MO630442550BR3165XRDXX301

Contacts

Secure Messaging
hwoldgeorgis10513@direct-ehr-ssmhc.com
FHIR Endpoint
https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness95
Years active:12State licenses:1Other names

7,017 NURSE PRACTITIONER in MO

Provider Addresses for HIWOT WOLDGEORGIS

  • 1634 HURSTBOROUGH MANOR DR

    HAZELWOOD, MO 630421584

    Phone:

    Type: Mailing

  • 3440 DE PAUL LN

    BRIDGETON, MO 630443545

    Phone: (314) 739-1333

    Type: Location

  • 3440 De Paul Ln

    Bridgeton, MO 630443545

    Phone: (314) 739-1333

    Type: Location

  • PO BOX 955534

    SAINT LOUIS, MO 631955534

    Phone:

    Type: Mailing

  • 3165 MCKELVEY RD STE 100

    BRIDGETON, MO 630442550

    Phone: (314) 739-1333

    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: 2014-03-01

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20140301000041INurse PractitionerMOTBD

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
99308Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes18386$0
99309Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes9882$0
View full utilization report →

Insurance plans in this area (ZIP 63042)

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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: 9133123102View full group profile
NameSpecialtyState
Internal MedicineMO
Internal MedicineMO

Reviews

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Frequently asked questions

How is HIWOT WOLDGEORGIS identified in CMS data?
CMS-hosted NPPES data lists HIWOT WOLDGEORGIS with NPI 1265856215.
Can I rely on HIWOT WOLDGEORGIS being an active provider?
As of the registry snapshot, HIWOT WOLDGEORGIS is marked active.
What is HIWOT WOLDGEORGIS's primary classification?
Nurse Practitioner is the headline specialty for HIWOT WOLDGEORGIS here. Clinical services aligned with this taxonomy classification.
What area does HIWOT WOLDGEORGIS serve?
HIWOT WOLDGEORGIS's listing highlights Hazelwood, Missouri; more addresses can appear in NPPES.
Why does HIWOT WOLDGEORGIS have multiple addresses?
5 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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