ZEYERUSALEM WOLDESILASSE
NPI 1174292767
Nurse Practitioner - Primary Care in Sacramento, CA
About Zeyerusalem Woldesilasse NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ZEYERUSALEM WOLDESILASSE (NPI 1174292767) is an individual primary care provider in Sacramento, California, licensed in California (NP95016910) and active in the NPI registry since September 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2020).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Zeyerusalem Woldesilasse is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
6Medicare enrollment records show Zeyerusalem Woldesilasse reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Fair Oaks, CA 95628
- Reassigned Medicare billing, California enrollment
- 36 clinicians in this Medicare group
Carmichael, CA 95608
- Reassigned Medicare billing, California enrollment
- 72 clinicians in this Medicare group
Elk Grove, CA 95758
- Reassigned Medicare billing, California enrollment
- 23 clinicians in this Medicare group
Vacaville, CA 95687
- Reassigned Medicare billing, California enrollment
- Medicare enrollment name: Northbay Physicians Surgery Center, LLC
- 516 clinicians in this Medicare group
Stockton, CA 95210
- Reassigned Medicare billing, California enrollment
- 20,078 clinicians in this Medicare group
Fairfield, CA 94534
- Reassigned Medicare billing, California enrollment
- 225 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 2
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 95827 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Zeyerusalem Woldesilasse's NPI number?
The NPI number for Zeyerusalem Woldesilasse is 1174292767. It was assigned to this individual provider in the NPPES registry on September 8, 2021.
Where is Zeyerusalem Woldesilasse located?
Zeyerusalem Woldesilasse practices at 10385 Old Placerville Rd, Sacramento, CA 95827. The listed phone number is (916) 448-1770.
What is Zeyerusalem Woldesilasse's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.
Is Zeyerusalem Woldesilasse enrolled in Medicare?
Yes. Zeyerusalem Woldesilasse is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Zeyerusalem Woldesilasse's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Zeyerusalem Woldesilasse reassigns Medicare benefits to 6 organizations: Chandan Ds Cheema MD Inc (Fair Oaks, CA), All Inclusive Medical Services, Inc (Carmichael, CA), Elk Grove Urgent Care Inc (Elk Grove, CA), Northbay Healthcare Group (Vacaville, CA), Permanente Medical Group Inc (Stockton, CA) and 1 more organization, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Zeyerusalem Woldesilasse's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Zeyerusalem Woldesilasse was last updated on September 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.
# Zeyerusalem Woldesilasse · NPI 1174292767
Primary Care physician in Sacramento, California. Individual provider, active in the CMS NPPES registry since September 8, 2021.
## Identity
- **NPI:** 1174292767 (Entity type: Individual)
- **Enumerated:** September 8, 2021
- **Primary specialty:** Nurse Practitioner - Primary Care · taxonomy 363LP2300X
- **State license:** NP95016910 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 10385 OLD PLACERVILLE RD, Sacramento, CA 95827-2506
- **Phone:** (916) 448-1770 · **Fax:** (916) 448-3015
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 6 organizations under Medicare reassignment (form CMS-855R): Chandan Ds Cheema MD Inc (NPI 1598965667, Fair Oaks, CA); All Inclusive Medical Services, Inc (NPI 1518369891, Carmichael, CA); Elk Grove Urgent Care Inc (NPI 1285812024, Elk Grove, CA); Northbay Healthcare Group (NPI 1255483202, Vacaville, CA); Permanente Medical Group Inc (NPI 1548343510, Stockton, CA); and 1 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2020
## Record status
- **NPPES last updated:** September 8, 2021
- **Other identifiers:** Medicaid NP95016910 (CA)
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Source: [NPI Profile](https://npiprofile.com/npi/1174292767) · Data from the CMS NPPES public registry.