Mereb Habtetsion, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

53851 Issued in CA

Practice address

243 Georgia St Ste B
Vallejo, CA 94590-5905

Phone

(707) 556-8100

NPI assigned

Oct 13, 2016

Sex

Male

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

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alameda Health SystemGroup PAC ID 3779494521, 597 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Alameda Health System

  • Surgery Physician
  • Oakland, CA
  • NPI 1740332931
  Medicare reassignment Care Compare group
• Alameda Health System

  • Federally Qualified Health Center (FQHC)
  • Newark, CA
  • NPI 1497956288
  NPD
• Alameda Health System

  • Federally Qualified Health Center (FQHC)
  • Oakland, CA
  • NPI 1932300738
  NPD
• La Clinica de la Raza Inc

  • Federally Qualified Health Center (FQHC)
  • Vallejo, CA
  • NPI 1992811392
  NPD (past)

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

{
    "created_epoch": "1476316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522540800000",
    "number": "1285184242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 VERNON ST APT 2",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946104241",
            "telephone_number": "510-260-4059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 GEORGIA ST STE B",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945905905",
            "telephone_number": "707-556-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABTETSION",
        "first_name": "MEREB",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-13",
        "last_updated": "2018-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "53851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mikhail Gutkin, PHD
• Ana Belem Guzman
• Jovita Guzman, OTR/L
• Francis K. Gyorkey, PSY. D.
• Patricia Ann Haas, MSW
• Adnan Joseph Hadeed, MD
• Jenna Hadick, AMFT
• Natalie Rose Haffner, DPT
• Shane Douglas Hagan
• Kathleen Beth Hahn, PNP

• Physician Assistant in Vallejo, CA
• Providers in Vallejo, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2018; 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.