Mellat Abebe – Case Manager/Care Coordinator

Key facts

NPI: 1366040248
Entity type: Individual (NPI type 1)
Primary specialty: Case Manager/Care Coordinator 171M00000X
Practice address: 815 N El Centro Ave
Los Angeles, CA 90038-3805
Phone: (626) 649-9751
NPI assigned: Oct 13, 2020
Sex: Female
Sole proprietor: No

Organizations & group practices 1

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.

Aces 2020, LLC Behavior Analyst · San Diego, CA · NPI 1467520452

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Practice roles

Organization	Specialty	Status	New patients
Aces 2020, LLC		Past since Oct 1, 2020	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Case Manager/Care Coordinator	171M00000X		CA	Yes
Case Manager/Care Coordinator	171M00000X

Addresses

Primary practice location

815 N El Centro Ave
Los Angeles, CA 90038-3805

Mailing address

815 N El Centro Ave
Los Angeles, CA 90038-3805

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 10, 2024.

{
    "created_epoch": "1602547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1366040248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 N EL CENTRO AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900383805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 N EL CENTRO AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900383805",
            "telephone_number": "626-649-9751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABEBE",
        "first_name": "MELLAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-13",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

All providers in Los Angeles, CA · Case Manager/Care Coordinator in California

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 10, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.