Individual provider Active NPI

Denia Pondexter

  • Family Nurse Practitioner
  • La Mesa, CA
National Provider Identifier
1114236064
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
23614 Issued in CA
Practice address
5555 Grossmont Center Dr
La Mesa, CA 91942-3019
Phone
(619) 740-6000
Fax
(619) 906-4564
NPI assigned
Sep 27, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 23614 CA Primary

Addresses

Primary practice location

5555 Grossmont Center Dr
La Mesa, CA 91942-3019

Mailing address

5555 Grossmont Center Dr
La Mesa, CA 91942-3019
Phone (619) 740-6000

Electronic endpoints 1

TypeEndpointUseAffiliation
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

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20141209001185 CA Practitioner - Nurse Practitioner 9032304993 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians
Team Physicians of Northern California Medical Group IncGroup PAC ID 7113215146, 84 clinicians
Clinic Services of California Medical Group IncGroup PAC ID 7810209715, 65 clinicians

Practice addresses (Care Compare)

411 N Lakeview Ave
Anaheim, CA 92807-3028
Phone (714) 279-4000

5555 Grossmont Ctr Dr
La Mesa, CA 91942-3019
Phone (619) 465-0711

8851 Ctr Dr
Suite 600
La Mesa, CA 91942-3061
Phone (619) 740-5724

Hospital & facility affiliations

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

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
81.04
Promoting interoperability
99
Improvement activities
40
Cost
82.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
23614CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Team Physicians of Northern California Medical Group Inc CurrentSince Aug 19, 2016 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Mar 22, 2019 Accepting new patients
Clinic Services of California Medical Group Inc CurrentSince Sep 1, 2022 Accepting new patients
BL Anderson Medical Corporation CurrentSince Nov 3, 2021 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 22, 2022 Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 22, 2022 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Mar 22, 2019 Accepting new patients
Dr Carneiro Wound Medicine Corp CurrentSince Aug 13, 2023 Accepting new patients
Apex Emergency Medical Group, Inc. CurrentSince Sep 10, 2014 Accepting new patients
Southbay Urgent Care Inc CurrentSince Oct 15, 2022 Accepting new patients
Arizona Pulmonary Specialists LTD PastSince Jan 1, 1997 Accepting new patients

Locations

411 N Lakeview Ave
Anaheim, CA 92807
Phone (714) 279-4000

525 Third Ave
Chula Vista, CA 91910
Phone (619) 585-4050

1117 E Devonshire Ave
Hemet, CA 92543
Phone (951) 652-2811

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

8851 Center Dr
Ste 600
La Mesa, CA 91942
Phone (619) 589-0785

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

10890 Thornmint Rd
Ste 202
San Diego, CA 92127
Phone (855) 745-8400

555 Saturn Blvd
Ste B
San Diego, CA 92154
Phone (619) 591-9999

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

1628 Palm Ave
San Diego, CA 92154
Phone (303) 513-8725

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71750

Organizations & group practices 12

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

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1285545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1114236064",
    "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": "619-740-6000",
            "fax_number": "619-906-4564"
        },
        {
            "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": "619-740-6000",
            "fax_number": "619-906-4564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONDEXTER",
        "first_name": "DENIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-27",
        "last_updated": "2023-09-26",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "23614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.