Taddese Teferi Desta, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

A49164 Issued in CA

Practice address

292 Euclid Ave
Suite 115
San Diego, CA 92114-3643

Phone

(619) 266-3332

Fax

(619) 266-6000

NPI assigned

Oct 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Oregon Health Sciences University School of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Digestive Disease Associates IncGroup PAC ID 9436052164, 7 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: tdesta80950@scrippshlth.medalliesdirect.net
• Direct secure messaging: tdesta34092@sharphealthcare.direct-ci.com

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.

• Digestive Disease Associates, Inc

  • Specialist
  • San Diego, CA
  • NPI 1073699971
  Medicare reassignment Care Compare group NPD
• Emergency and Acute Care Medical Corporation

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1437103942
  Medicare reassignment NPD
• Euclid Endoscopy Center, LLC

  • Ambulatory Surgical Clinic/Center
  • San Diego, CA
  • NPI 1205853041
  Medicare reassignment NPD
• Scripps Health

  • Multi-Specialty Clinic/Center
  • La Jolla, CA
  • NPI 1275899072
  Medicare reassignment NPD
• Scripps Health

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1487928891
  NPD
• Scripps Health

  • Home Health Agency
  • San Diego, CA
  • NPI 1578556114
  NPD
• Scripps Health

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • La Jolla, CA
  • NPI 1619108503
  NPD
• Southern California Gastroenterology Anesthesia Specia

  • Certified Registered Nurse Anesthetist
  • San Diego, CA
  • NPI 1073997359
  NPD
• Paradise Valley Hospital

  • General Acute Care Hospital
  • National City, CA
  • NPI 1598756710
  NPD (past)
• Scripps Health

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1659359446
  NPD (past)
• Sharp Chula Vista Medical Center

  • Skilled Nursing Facility
  • Chula Vista, CA
  • NPI 1538142369
  NPD (past)

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1346326246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "292 EUCLID AVE STE 115",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921143629",
            "telephone_number": "619-266-3332",
            "fax_number": "619-266-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "292 EUCLID AVE",
            "address_2": "SUITE 115",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921143643",
            "telephone_number": "619-266-3332",
            "fax_number": "619-266-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESTA",
        "first_name": "TADDESE",
        "middle_name": "TEFERI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A49164",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A49164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A491640",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "taddesedesta@ddd.allscriptsdirect.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "292 Euclid Ave",
            "address_2": "SUITE 115",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921143643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Derek Reece Desrosiers
• Patricia J Desrosiers
• Gary Desrouilleres, PTA
• Marianne Elyse Dessert
• Alexander Kareem Desta, D.D.S.
• Emily Paige Destefano, ND
• Destiny Medical Supplies
• Latoya Desue, LMFT
• Ajai Scott Desulme
• Tia Rachael Deswert

• Gastroenterology Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; 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.