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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

AEDEN GHEBRESELASSIE CRNP
NPI 1093051237
Nurse Practitioner - Family in St Johns, FL

Active since December 17, 2012PECOS Enrolled
2001 COUNTY ROAD 210 W STE 200, ST JOHNS, FL 32259(904) 450-8120(904) 230-1066 Get Directions Write a Review

NPPES record last updated: October 20, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Aeden Ghebreselassie Crnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AEDEN GHEBRESELASSIE CRNP (NPI 1093051237) is an individual family provider in St Johns, Florida, licensed in Florida (APRN11032157) and active in the NPI registry since December 2012. She is enrolled in Medicare PECOS and maintains a secondary practice location in Mc Lean.

NPPES Registry Identity

NPI1093051237
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameAEDEN GHEBRESELASSIECredential: CRNP
Location Address2001 COUNTY ROAD 210 W STE 200St Johns, FL 32259-1181
Mailing Address2001 County Road 210 W Ste 200St Johns, FL 32259-1181 · (904) 450-8120 · Fax (904) 230-1066
Phone(904) 450-8120
Fax(904) 230-1066
Sole ProprietorNo
Enumeration DateDecember 17, 2012
Last NPPES UpdateOctober 20, 2026
NPPES CertifiedOctober 20, 2026
✔ NPI 1093051237 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Licenses✔ Licensed in FL · APRN11032157✔ Licensed in VA · 0024174118
2001 COUNTY ROAD 210 W STE 200, St Johns, FL 32259
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Secondary Practice Location 1

Location 11680 Capital One DrMc Lean, VA 22102-3407 · Phone (703) 720-1290 · Fax (703) 720-1291

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Aeden Ghebreselassie Crnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32259 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AUSTIN J CHAPUT D.O.
Family Medicine
2001 COUNTY ROAD 210 W STE 200
JACKSONVILLE, FL 32259
St. Johns County (904) 450-8120
SOUTHEAST ORTHOPEDIC SPECIALISTS, LLC
Specialist
2001 COUNTY ROAD 210 W STE 200
SAINT JOHNS, FL 32259
St. Johns County (904) 634-0640
DR. JAMI S WEBSTER M.D.
Pediatrics
2001 COUNTY ROAD 210 W STE 200
ST JOHNS, FL 32259
St. Johns County (044) 508-1209

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Aeden Ghebreselassie's NPI number?

The NPI number for Aeden Ghebreselassie is 1093051237. It was assigned to this individual provider in the NPPES registry on December 17, 2012.

Where is Aeden Ghebreselassie located?

Aeden Ghebreselassie practices at 2001 County Road 210 W Ste 200, St Johns, FL 32259. The listed phone number is (904) 450-8120.

What is Aeden Ghebreselassie's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Aeden Ghebreselassie enrolled in Medicare?

Yes. Aeden Ghebreselassie is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Aeden Ghebreselassie was last updated on October 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.