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KIDIST FISSEHA
NPI 1356032262
Nurse Practitioner - Family in Lehi, UT

Active since May 19, 2023PECOS Enrolled
1633 W INNOVATION WAY FL 4, LEHI, UT 84043(855) 726-6363(801) 784-1482 Get Directions Write a Review

NPPES record last updated: July 25, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 25, 2024, Jun 6, 2023, May 26, 2023 and 1 more (4 updates tracked since 2023).

About Kidist Fisseha NPPES

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

KIDIST FISSEHA (NPI 1356032262) is an individual family provider in Lehi, Utah, licensed in Utah (9115682-4405) and active in the NPI registry since May 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1356032262
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameKIDIST FISSEHA
Location Address1633 W INNOVATION WAY FL 4Lehi, UT 84043-4252
Mailing Address1633 W Innovation Way Fl 4Lehi, UT 84043-4252 · (855) 726-6363 · Fax (801) 784-1482
Phone(855) 726-6363
Fax(801) 784-1482
Sole ProprietorNo
Enumeration DateMay 19, 2023
Last NPPES UpdateJuly 25, 20244 updates tracked since enumeration
NPPES CertifiedJuly 25, 2024
✔ NPI 1356032262 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in UT · 9115682-4405
Also ListedRegistered NurseTaxonomy 163W00000X · License 1009883 (TX)
1633 W INNOVATION WAY FL 4, Lehi, UT 84043
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kidist Fisseha 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 84043 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
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$96.35 typical visit price
range $17.23 – $135.20
Typical copayment $24.08 (range $4.30 – $33.80)
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 2

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

BRANDON ROBERT KENT APRN
Nurse Practitioner (Family)
1633 W INNOVATION WAY FL 4
LEHI, UT 84043
Utah County (855) 726-6363
CYNTHIA DIANE JONES APRN-CNP
Nurse Practitioner (Adult Health)
1633 W INNOVATION WAY FL 4
LEHI, UT 84043
Utah County (800) 640-3451

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 Kidist Fisseha's NPI number?

The NPI number for Kidist Fisseha is 1356032262. It was assigned to this individual provider in the NPPES registry on May 19, 2023.

Where is Kidist Fisseha located?

Kidist Fisseha practices at 1633 W Innovation Way Fl 4, Lehi, UT 84043. The listed phone number is (855) 726-6363.

What is Kidist Fisseha's specialty?

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

Is Kidist Fisseha enrolled in Medicare?

Yes. Kidist Fisseha is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kidist Fisseha was last updated on July 25, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.