Mahalia T Dejesus, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

003347 Issued in CT

Practice address

7 Cambridge Dr Ste 201
Trumbull, CT 06611-4763

Phone

(203) 335-0195

Fax

(203) 335-7293

NPI assigned

May 9, 2006

Last updated

Feb 18, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Nurse Practitioner

Education

Other, 2005

Medicare assignment

May accept Medicare assignment

Group practices

Nephrology Associates PCGroup PAC ID 4981590627, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Nephrology Associates, PC

  • Nephrology Physician
  • Trumbull, CT
  • NPI 1609825223

  Family

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1578512323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CAMBRIDGE DR STE 201",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066114763",
            "telephone_number": "203-335-0195",
            "fax_number": "203-335-7293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 CAMBRIDGE DR STE 201",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066114763",
            "telephone_number": "203-335-0195",
            "fax_number": "203-335-7293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJESUS",
        "first_name": "MAHALIA",
        "middle_name": "T",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-09",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "003347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578512323",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004261799",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Louis Debernardo Sr., M.D., MPH
• Laura K Degeorge, APRN, NP-C
• Cooper Thomas Degirolomo, EMT-B
• Noel C Degray
• Ira Jeffrey Deitz, M.D.
• Jaycie Deleon Perez, RD
• Carolina Deleon, LO
• Nicholas Delibero
• Robert Dembosky
• Pantelis Demestihas, RPH, MS

• Family Nurse Practitioner in Trumbull, CT
• Providers in Trumbull, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.