Individual provider Active NPI

Menberemedhin Abera Tegegne

  • Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1407141609
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP95027625 Issued in CA
Practice address
427 C St
Suite 212
San Diego, CA 92101-5100
Phone
(619) 238-4180
Fax
(619) 238-4245
NPI assigned
Jun 15, 2011
Last updated
Apr 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP95027625 CA Primary

Addresses

Primary practice location

427 C St
Suite 212
San Diego, CA 92101-5100

Mailing address

2011 Arden Ave Apt L292
Highland, CA 92346-5149
Phone (858) 222-7938

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240117002478 CA Practitioner - Nurse Practitioner 1951753748 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Onclick Healthcare IncorporatedGroup PAC ID 9830511260, 63 clinicians
Greater Good Health PC IncGroup PAC ID 5294106027, 48 clinicians

Practice addresses (Care Compare)

Calabasas, CA 91302
Phone (818) 230-2116

100 W Washington Blvd
Montebello, CA 90640-6211
Phone (800) 424-6598

1824 E Slauson Ave
Vernon, CA 90058-3829
Phone (800) 424-6598

2625 Townsgate Rd
Suite 330
Westlake Village, CA 91361-5749

300 Continental Blvd
Suite 635
El Segundo, CA 90245-5040
Phone (310) 658-3775

5807 Avalon Blvd
Los Angeles, CA 90011-5303
Phone (800) 424-6598

7612 Atlantic Ave
Cudahy, CA 90201-5020
Phone (800) 424-6598

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NP95027625CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Good Health PC, Inc. CurrentSince May 8, 2025 Accepting new patients
Ehab Yacoub MD Inc. CurrentSince Jan 15, 2024 Accepting new patients
Onclick Healthcare Incorporated CurrentSince Jan 19, 2026 Accepting new patients
Villagehealth DM LLC CurrentSince May 1, 2025 Accepting new patients
Greater Good Health PC, Inc. Nurse Practitioner CurrentSince May 8, 2025 Accepting new patients
Easy Health Medical Solutions PC Nurse Practitioner CurrentSince May 1, 2025 Accepting new patients

Locations

300 Continental Blvd
Ste 635
El Segundo, CA 90245
Phone (310) 658-3775

601 Hawaii St
El Segundo, CA 90245
Phone (310) 536-2400

1225 W 190th St
Ste 280
Gardena, CA 90248
Phone (310) 515-8113

1180 S Beverly Dr
Ste 700
Los Angeles, CA 90035
Phone (213) 584-2331

17075 Devonshire St
Ste 204
Northridge, CA 91325
Phone (818) 368-8929

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1308096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1407141609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 ARDEN AVE APT L292",
            "city": "HIGHLAND",
            "state": "CA",
            "postal_code": "923465149",
            "telephone_number": "858-222-7938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 C ST",
            "address_2": "SUITE 212",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921015100",
            "telephone_number": "619-238-4180",
            "fax_number": "619-238-4245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEGEGNE",
        "first_name": "MENBEREMEDHIN",
        "middle_name": "ABERA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-15",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95027625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.