Active NPI
Beniyam Degaga
- Driver
- Buena Park, CA
National Provider Identifier
1548021546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- F1371238
- Practice address
- 6881 Stanton Ave
Buena Park, CA 90621-3648 - Phone
- (424) 386-5957
- NPI assigned
- Jan 17, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | F1371238 | CA | Primary |
Addresses
Primary practice location
6881 Stanton Ave
Buena Park, CA 90621-3648
Mailing address
8111 Stanford Ave SPC 134
Garden Grove, CA 92841-4363
Phone (424) 386-5957
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F1371238 | CA | MD | Driver |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ez-2-Ride LLC | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Non-emergency Medical Transport (VAN)
- Anaheim, CA
- NPI 1265264055
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1705449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705449600000",
"number": "1548021546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8111 STANFORD AVE SPC 134",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928414363",
"telephone_number": "424-386-5957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6881 STANTON AVE",
"city": "BUENA PARK",
"state": "CA",
"postal_code": "906213648",
"telephone_number": "424-386-5957"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEGAGA",
"first_name": "BENIYAM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-01-17",
"last_updated": "2024-01-17",
"certification_date": "2024-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "CA",
"license": "F1371238",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buena Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.