Individual provider Active NPI

Manuel Dejesus, MD

  • Emergency Medicine Physician
  • Rancho Mirage, CA
National Provider Identifier
1366463366
Registry record updated Dec 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A86981 Issued in CA
Practice address
39000 Bob Hope Dr
Rancho Mirage, CA 92270-3221
Phone
(760) 773-1221
NPI assigned
Jul 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A86981 CA Primary

Addresses

Primary practice location

39000 Bob Hope Dr
Rancho Mirage, CA 92270-3221

Mailing address

39000 Bob Hope Dr
Rancho Mirage, CA 92270-3221
Phone (760) 773-1221

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040709000343 CA Practitioner - Emergency Medicine 6103718960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.87 of 100Reported as group
Quality
85.37
Promoting interoperability
100
Improvement activities
40
Cost
74.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Eisenhower Medical Center CurrentSince Dec 1, 2015 Accepting new patients
Eisenhower Medical Center CurrentSince Dec 1, 2015 Accepting new patients
Emergency Physicians Medical Group, Inc Emergency Medicine Past Accepting new patients

Locations

72201 Country Club Dr
Rancho Mirage, CA 92270
Phone (760) 340-5999

39000 Bob Hope Dr
Ste 310
Rancho Mirage, CA 92270

39950 Vista del Sol
Rancho Mirage, CA 92270
Phone (760) 340-0053

39000 Bob Hope Dr
Rancho Mirage, CA 92270
Phone (760) 340-3911

39000 Bob Hope Dr
#C
Rancho Mirage, CA 92270
Phone (760) 837-8014

39000 Bob Hope Dr
Ofc
Rancho Mirage, CA 92270
Phone (760) 333-1813

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449100800000",
    "number": "1366463366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DR",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703221",
            "telephone_number": "760-773-1221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DR",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703221",
            "telephone_number": "760-773-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJESUS",
        "first_name": "MANUEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2015-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A86981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

Verify at the official NPI Registry.