Individual provider Active NPI

Derick Mensah, CRNP

  • Family Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1144081613
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95027897 Issued in CA
Practice address
7675 Mission Valley Rd
San Diego, CA 92108-4429
Phone
(800) 316-6314
NPI assigned
Jan 22, 2024
Last updated
Jan 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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 95027897 CA Primary

Addresses

Primary practice location

7675 Mission Valley Rd
San Diego, CA 92108-4429

Mailing address

7675 Mission Valley Rd
San Diego, CA 92108-4429
Phone (800) 316-6314

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC, VA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20240311003566 MD Practitioner - Nurse Practitioner 3476999517 Reassigns benefits to 1 organization
I20250717003041 DC Practitioner - Nurse Practitioner 3476999517 Reassigns benefits to 2 organizations
I20250912001022 VA Practitioner - Nurse Practitioner 3476999517 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inova Health Care ServicesGroup PAC ID 2466351093, shared by 24 NPIs, 1,821 clinicians
Lifebridge Orthopedic Specialists LLCGroup PAC ID 4082928098, 46 clinicians

Practice addresses (Care Compare)

3300 Gallows Rd
Falls Church, VA 22042-3307

3800 Fettler Park Dr
Suite 312
Dumfries, VA 22025-2043
Phone (571) 472-6791

44045 Rivderside Pkwy
Leesburg, VA 20176-5101
Phone (703) 771-2960

5415 Old Court Rd
S04
Randallstown, MD 21133-5170
Phone (410) 701-4437

8081 Innovation Park Dr
Fairfax, VA 22031-4867

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95027897CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Jun 23, 2025 Accepting new patients
Inova Health Care Services CurrentSince Jun 23, 2025 Accepting new patients
Lifebridge Orthopedic Specialists, LLC CurrentSince Mar 11, 2024 Accepting new patients
Inova Health Care Services CurrentSince Jun 23, 2025 Accepting new patients

Locations

2401 W Belvedere Ave
Baltimore, MD 21215

5415 Old Court Rd
Ste S04
Randallstown, MD 21133
Phone (410) 701-4437

3800 Fettler Park Dr
Ste 312
Dumfries, VA 22025
Phone (571) 472-6791

8081 Innovation Park Dr
Ste 900
Fairfax, VA 22031
Phone (571) 472-4200

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

7051 Heathcote Village Way
Ste 230
Gainesville, VA 20155
Phone (703) 391-4500

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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": "1705881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1144081613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7675 MISSION VALLEY RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084429",
            "telephone_number": "800-316-6314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7675 MISSION VALLEY RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084429",
            "telephone_number": "800-316-6314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENSAH",
        "first_name": "DERICK",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-22",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95027897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.