Individual provider Active NPI

Donald S Adema, DO

  • Family Medicine Physician
  • Santee, CA
National Provider Identifier
1487763512
Registry record updated Sep 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A6239 Issued in CA
Practice address
10201 Mission Gorge Rd
#M
Santee, CA 92071
Phone
(619) 596-5445
Fax
(619) 596-6923
NPI assigned
Aug 30, 2006
Last updated
Sep 6, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A6239 CA Primary

Addresses

Primary practice location

10201 Mission Gorge Rd
#M
Santee, CA 92071

Mailing address

10201 Mission Gorge Rd
#M
Santee, CA 92071
Phone (619) 596-5445

Other identifiers 3

IdentifierTypeStateIssuer
ZZZ48102ZOtherCABLUE SHIELD
00AX62390MedicaidCA
20A6239OtherCALICENSE

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
I20080317000605 CA Practitioner - Family Practice 4789769647 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6239CAMDOptometrist
20A6239CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adema Family Medicine, Inc Family Medicine CurrentSince May 1, 2007 Accepting new patients
Alpine Creek and Pine Valley Family Medicine Inc. Family Medicine Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Grossmont Hospital Corporation Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: dadema@ccf-tx.direct.office.nextgen.com
  • Direct secure messaging: dradema@direct.meditouchehr.com

Organizations & group practices 4

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346889600000",
    "number": "1487763512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10201 MISSION GORGE RD",
            "address_2": "#M",
            "city": "SANTEE",
            "state": "CA",
            "postal_code": "92071",
            "telephone_number": "619-596-5445",
            "fax_number": "619-596-6923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10201 MISSION GORGE RD",
            "address_2": "#M",
            "city": "SANTEE",
            "state": "CA",
            "postal_code": "92071",
            "telephone_number": "619-596-5445",
            "fax_number": "619-596-6923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEMA",
        "first_name": "DONALD",
        "middle_name": "S",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2012-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A6239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ48102Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX62390",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "20A6239",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santee, CA

Sources for this page

Verify at the official NPI Registry.