TESHOME SHIKESSO (NP PSYCH/MENTAL HEAL) – Registered Nurse, NPI 1124592357

TESHOME SHIKESSO (NP PSYCH/MENTAL HEAL) is a healthcare provider. based in Everett, Washington. specializing in NURSE PRACTITIONER. They hold the professional credentials NP PSYCH/MENTAL HEAL. They hold a License No. AP61323848 (WA). The NPI Number for TESHOME SHIKESSO (NP PSYCH/MENTAL HEAL) is 1124592357

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
TESHOME SHIKESSO (NP PSYCH/MENTAL HEAL)
NPI
1124592357
Phone
(425) 609-4522
Address
6C W INTERCITY AVE
Enumeration Date
22 January 2019
Last Update Date
15 August 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8442025555
Graduation Year
2022 (4 years ago)
PAC ID
7214311760
Group Practice PAC ID
7416233549
Professional Enrollment ID
I20220831003665
Address ID
WA982714831MA3955XNEXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness75
Years active:7State licenses:1Digital endpointsOther names

6,268 NURSE PRACTITIONER in WA

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Provider Addresses for TESHOME SHIKESSO (NP PSYCH/MENTAL HEAL)

  • West Intercity Avenue, Intercity, Everett, Snohomish County, Washington, 98204, United States

    EVERETT, WA 982042730

    Phone: (425) 609-4522

    Type: Location

  • 3955 156TH ST NE

    MARYSVILLE, WA 982714831

    Phone: (360) 651-6400

    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: 2022-08-31

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
I20220831003665INurse PractitionerWATBD

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 98204)

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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: 7416233549View full group profile
NameSpecialtyState
P S Y C H I A T R YPA
Nurse PractitionerWA
Nurse PractitionerWA
Nurse PractitionerTX
-WA
Nurse PractitionerWA
Nurse PractitionerWA
Nurse PractitionerNV
Nurse PractitionerWA
Nurse PractitionerWA

Reviews

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Frequently asked questions

How do payers reference TESHOME SHIKESSO (NP PSYCH/MENTAL HEAL)?
For TESHOME SHIKESSO (NP PSYCH/MENTAL HEAL), use NPI 1124592357 as the unique 10-digit identifier.
Would TESHOME SHIKESSO (NP PSYCH/MENTAL HEAL) appear as active to a payer?
You can treat TESHOME SHIKESSO (NP PSYCH/MENTAL HEAL) as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is TESHOME SHIKESSO (NP PSYCH/MENTAL HEAL)?
TESHOME SHIKESSO (NP PSYCH/MENTAL HEAL) is associated with Registered Nurse in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with TESHOME SHIKESSO (NP PSYCH/MENTAL HEAL)?
Directory geography for TESHOME SHIKESSO (NP PSYCH/MENTAL HEAL) centers on Everett, Washington.
Does TESHOME SHIKESSO (NP PSYCH/MENTAL HEAL) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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