Individual provider Active NPI

Deborah Ann Massetti, PA

  • Nurse Practitioner
  • Madera, CA
National Provider Identifier
1508996422
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP3398 Issued in CA
Practice address
1111 W 4TH St
Madera, CA 93637-4474
Phone
(559) 673-3000
Fax
(559) 662-2910
NPI assigned
Mar 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 NP3398 CA Primary

Addresses

Primary practice location

1111 W 4TH St
Madera, CA 93637-4474

Mailing address

1111 W 4TH St
Madera, CA 93637-4474
Phone (559) 673-3000

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
I20150209000367 CA Practitioner - Nurse Practitioner 3072838366

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1111 W 4TH St BLD B
Madera, CA 93637-4474

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Physician Assistant

State licenses

LicenseStateTypeSpecialty
8398CAMDOccupational Therapist
NP3398CAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508996422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 W 4TH ST",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936374474",
            "telephone_number": "559-673-3000",
            "fax_number": "559-662-2910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 W 4TH ST",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936374474",
            "telephone_number": "559-673-3000",
            "fax_number": "559-662-2910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSETTI",
        "first_name": "DEBORAH",
        "middle_name": "ANN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP3398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madera, CA

Sources for this page

Verify at the official NPI Registry.