Erene Yustina Abdelmeseeh, MD
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Las Vegas, NV
NPI 1104453257 · NPPES record last updated Oct 27, 2023
Key facts
- NPI
- 1104453257
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 2880 N Tenaya Way
Las Vegas, NV 89128-0618 - Phone
- (702) 962-9540
- NPI assigned
- Mar 26, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southern California Permanente Medical Group
Practice addresses (Care Compare)
25821 Vermont Ave
Harbor City, CA 90710-3518
Phone (310) 325-5111
25825 Vermont Ave
Harbor City, CA 90710-3518
Phone (310) 325-5111
Hospital & facility affiliations
- Kaiser Foundation Hospital - South Bay
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230912003916 | CA | Practitioner - Internal Medicine | 8325462526 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current |
Accepting new patients | |
| Southern California Permanente Medical Group | Current |
Accepting new patients |
Locations
5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088
441 N Lakeview Ave
Anaheim, CA 92807
Phone (714) 279-4000
25825 Vermont Ave
Harbor City, CA 90710
Phone (310) 325-5111
393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
2880 N Tenaya Way
Las Vegas, NV 89128-0618
Mailing address
2880 N Tenaya Way
Las Vegas, NV 89128-0618
Phone (702) 962-9540
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Other providers in Las Vegas, NV
- Malak Abdelhamid
- Shamika Abdelkader
- Dalya Abdelmaged
- Rose Adel Abdelmalak
- Wilyam Abdelmalik
- Rizalyne May Abdelnour
- Shadi Abdelnour
- Nurya Abderahman
- Surrey Abderrazik
- Maria Michelle Abdo
All providers in Las Vegas, NV · Student in an Organized Health Care Education/Training Program in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.