EYERUSALEM TEFFERA – Physician Assistant, NPI 1437040367

EYERUSALEM TEFFERA is a healthcare provider. based in Henderson, Nevada. specializing in PHYSICIAN ASSISTANT. The NPI Number for EYERUSALEM TEFFERA is 1437040367

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
EYERUSALEM TEFFERA
NPI
1437040367
Phone
(702) 483-6200
Address
715 MALL RING CIR STE 202
Enumeration Date
10 July 2025
Last Update Date
4 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7029637000
Graduation Year
2025 (1 year ago)
PAC ID
7315425592
Group Practice PAC ID
4183763592
Professional Enrollment ID
I20260129001909
Address ID
NV890114800HE1050XDRXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience15
Completeness85
Years active:0State licenses:0Digital endpointsOther names

1,223 PHYSICIAN ASSISTANT in NV

Provider Addresses for EYERUSALEM TEFFERA

  • 715 MALL RING CIR STE 202

    HENDERSON, NV 890146667

    Phone: (702) 483-6200

    Fax: (702) 483-6202

    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)

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: 2026-01-29

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
I20260129001909IPhysician AssistantNVTBD

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 89014)

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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: 4183763592View full group profile
NameSpecialtyState
Physician AssistantNV
-NV
Nurse PractitionerFL
Internal Medicine, Pulmonary Disease, Critical Care (Intensivists)NV
Critical Care (Intensivists), Pulmonary DiseaseNV
Nurse PractitionerNV
Physician AssistantNV
Internal Medicine, Critical Care (Intensivists)IL
Nurse PractitionerTX
Pulmonary DiseaseNV

Reviews

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Frequently asked questions

How do payers reference EYERUSALEM TEFFERA?
For EYERUSALEM TEFFERA, use NPI 1437040367 as the unique 10-digit identifier.
Would EYERUSALEM TEFFERA appear as active to a payer?
You can treat EYERUSALEM TEFFERA as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with EYERUSALEM TEFFERA?
EYERUSALEM TEFFERA's record emphasizes Physician Assistant. Clinical services aligned with this taxonomy classification.
What locale is associated with EYERUSALEM TEFFERA?
Directory geography for EYERUSALEM TEFFERA centers on Henderson, Nevada.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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