Mary Rose E Meza, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95019535 Issued in CA

Practice address

1135 S Sunset Ave Ste 401
West Covina, CA 91790-3921

Phone

(626) 732-8391

NPI assigned

Mar 25, 2022

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Emanate Health Medical Care Foundation

  • Multi-Specialty Clinic/Center
  • West Covina, CA
  • NPI 1467195073
  Medicare reassignment NPD
• Emanate Health Medical Group

  • General Practice Physician
  • Covina, CA
  • NPI 1881054997
  NPD (past)

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

{
    "created_epoch": "1648166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1366192064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4825",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917637825",
            "telephone_number": "951-232-6394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 S SUNSET AVE STE 401",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903921",
            "telephone_number": "626-732-8391"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9961 Sierra Ave",
            "address_purpose": "LOCATION",
            "city": "Fontana",
            "state": "CA",
            "postal_code": "923356720",
            "country_code": "US",
            "telephone_number": "909-427-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1115 S Sunset Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "West Covina",
            "state": "CA",
            "postal_code": "917903940",
            "country_code": "US",
            "telephone_number": "626-732-8390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEZA",
        "first_name": "MARY ROSE",
        "middle_name": "E",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-25",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95019535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Athena Merianos, LMFT
• Sarah Sanam Meshkanian, DDS
• Raffaela Marie Meyer, PHARMD
• Eliana Meza
• Marisol Meza, C-SLPA, BS,
• Ana Michael
• David J Michelson, M.D.
• Enid Midley, ACSW
• Mikkon Adult Day Health Care Center
• Laura Dru Miles, LICENSED MARRIAGE AN

• Family Nurse Practitioner in West Covina, CA
• Providers in West Covina, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.