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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: November 01, 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
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignments

3

Medicare enrollment records show Kidist Fisseha reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Greater Good Health PC Inc
405 mi
Primary Care
1423 38TH ST W UNIT 3
Billings, MT 59102
  • Reassigned Medicare billing, Montana enrollment
  • 21 clinicians in this Medicare group
NPI 1285311258 (310) 658-3775
Signify Health, LLC
980 mi
General Practice
4055 VALLEY VIEW LN STE 700
Dallas, TX 75244
  • Reassigned Medicare billing, Utah enrollment
  • 145 clinicians in this Medicare group
NPI 1689158487 (469) 466-7007
Wellbe Utah LLC
1,264 mi
Internal Medicine
225 W WASHINGTON ST STE 1500
Chicago, IL 60606
  • Reassigned Medicare billing, Utah enrollment
  • 10 clinicians in this Medicare group
NPI 1568183523 (312) 776-2422

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

Which organizations bill Medicare for Kidist Fisseha's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kidist Fisseha reassigns Medicare benefits to 3 organizations: Greater Good Health PC Inc (Billings, MT), Signify Health, LLC (Dallas, TX) and Wellbe Utah LLC (Chicago, IL). 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 Kidist Fisseha'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 Kidist Fisseha was last updated on July 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.