FITSUM ABERA AKLILU — NPI 1730051087 (Licensed & Credentialed Community Based Residential Treatment Facility, Mental Illness in CLACKAMAS, OR)

CMS-1500 Box 24J / 33a • NPI

1730051087

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

320800000X

Licensed & Credentialed Community Based Residential Treatment Facility, Mental Illness

Box 32 Service Location & ZIP+4

11762 SE MARKET DR, CLACKAMAS, OR, 97015-8674

✓ 9-Digit EDI 837 ZIP+4 (97015-8674)

Practice Phone & Referral Fax

(971) 331-0569

Fax: (503) 698-5568

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1730051087 (FITSUM ABERA AKLILU) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1730051087` (NPI-1 Individual Practitioner)
Provider / Legal Name	FITSUM ABERA AKLILU
Plain-English Specialty	Licensed & Credentialed Community Based Residential Treatment Facility, Mental Illness NUCC Code: `320800000X` (Community Based Residential Treatment Facility, Mental Illness)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	11762 SE MARKET DR, CLACKAMAS, OR, 97015-8674
Practice Telephone / Fax	Tel: (971) 331-0569 \| Fax: (503) 698-5568
Administrative Mailing Address	12446 SE EAGLE GLEN DR, HAPPY VALLEY, OR, 97086-6499
Enumeration & Last Sync	Enumerated: 2025-09-18 \| CMS Record Updated: 2025-09-18

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

11762 SE MARKET DR, CLACKAMAS, OR, 97015-8674

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Plain-English Taxonomy & CMS Crosswalk (320800000X)

What Does Taxonomy Code 320800000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 320800000X translates to:
"Licensed & Credentialed Community Based Residential Treatment Facility, Mental Illness"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Community Based Residential Treatment Facility, Mental Illness for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (FITSUM ABERA AKLILU)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`320800000X` — Community Based Residential Treatment Facility, Mental Illness Plain English: Licensed & Credentialed Community Based Residential Treatment Facility, Mental Illness	State: OR \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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FITSUM ABERA AKLILU (NPI #1730051087)