Dana Ashli Derissi, P.A.-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA51577 Issued in CA

Practice address

5555 Grossmont Center Dr
La Mesa, CA 91942-3019

Phone

(619) 740-4071

NPI assigned

Jul 16, 2014

Last updated

Sep 3, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Stanford University School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Health Centers of San Diego IncGroup PAC ID 3476446378, 299 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grossmont Hospital Hospital, La Mesa, CA, CCN 050026

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dana.derissi.p27@direct.medcor.nextgenshare.com
• Direct secure messaging: dderissi330988@direct.llu.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Health Centers of San Diego, Inc

  dba Logan Heights Family Health Center

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1447281936
  Medicare reassignment Care Compare group
• Clinic Services of California Medical Group Inc

  • Emergency Medicine Physician
  • Lodi, CA
  • NPI 1578958450
  Medicare reassignment
• La Jolla Emergency Specialists

  • Emergency Medicine Physician
  • La Jolla, CA
  • NPI 1710315353
  Medicare reassignment
• La Jolla Observation Medicine

  • Emergency Medicine Physician
  • La Jolla, CA
  • NPI 1780122986
  Medicare reassignment
• Mint Health Solutions, Inc

  • Internal Medicine Physician
  • Pasadena, CA
  • NPI 1316543119
  Medicare reassignment
• Team Physicians of Northern California Medical Group Inc

  • Emergency Medicine Physician
  • Pleasanton, CA
  • NPI 1649692716
  Medicare reassignment
• Family Health Centers of San Diego, Inc

  dba City Heights Family Health Center

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1023054004
  NPD
• Family Health Centers of San Diego, Inc

  dba Escondido Physical Health and Wellness

  • Federally Qualified Health Center (FQHC)
  • Escondido, CA
  • NPI 1356178180
  NPD
• Emergency Medicine Physician Partners of Riverside County, Inc

  • Emergency Medicine Physician
  • Moreno Valley, CA
  • NPI 1750682712
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Grossmont Hospital Corporation

  dba Sharp Grossmont Hospital

  • General Acute Care Hospital
  • La Mesa, CA
  • NPI 1528041811
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1405468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1063829505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 GROSSMONT CENTER DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423019",
            "telephone_number": "619-740-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 GROSSMONT CENTER DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423019",
            "telephone_number": "619-740-4071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "556 S Fair Oaks Ave Ste 101-214",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911052656",
            "country_code": "US",
            "telephone_number": "323-250-3720",
            "fax_number": "657-888-7345",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3020 Childrens Way",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921234223",
            "country_code": "US",
            "telephone_number": "858-966-8800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9834 Genesee Ave Ste 221",
            "address_purpose": "LOCATION",
            "city": "LA Jolla",
            "state": "CA",
            "postal_code": "920371215",
            "country_code": "US",
            "telephone_number": "858-558-1275",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "525 E Main St",
            "address_purpose": "LOCATION",
            "city": "El Cajon",
            "state": "CA",
            "postal_code": "920204007",
            "country_code": "US",
            "telephone_number": "619-515-2498",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DERISSI",
        "first_name": "DANA",
        "middle_name": "ASHLI",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-16",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA51577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deluxe Medical Supply LLC
• Carina Demanigold
• Denise a Honer M.D. Inc
• Madeleine Elisabeth Denison
• Donna S Dennis, MA MFT
• Nicholas G Desantis, DC
• Matthew Desiderio, DMD
• Desiree Brittain
• Kelly Dewitt, MD
• Sukhman Dhaliwal, DO

• Medical Physician Assistant in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.