Meron Desta

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95023853 Issued in CA

Practice address

25880 McBean Pkwy
Santa Clarita, CA 91355-2004

Phone

(661) 254-3766

NPI assigned

May 4, 2023

Last updated

May 4, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Meron Desta Gessese Former name

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Los Angeles County Department of Public HealthGroup PAC ID 3072966621, 40 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.

• Los Angeles County Department of Public Health

  • Public Health & General Preventive Medicine Physician
  • Los Angeles, CA
  • NPI 1962109033
  Medicare reassignment Care Compare group NPD
• Gracelight Community Health

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1104075282
  Medicare reassignment NPD
• Gracelight Community Health

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1639241888
  NPD

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

{
    "created_epoch": "1683158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1598454563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 GOTHIC AVE",
            "city": "NORTH HILLS",
            "state": "CA",
            "postal_code": "913431246",
            "telephone_number": "818-304-2907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25880 MCBEAN PKWY",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913552004",
            "telephone_number": "661-254-3766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESTA",
        "first_name": "MERON",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-04",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95023853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MERON",
            "last_name": "GESSESE",
            "middle_name": "DESTA",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kavita M Deo, PSY.D.
• Shabnam Deriani, LCSW
• Lucine Dermidzhyan
• Desert Foot and Ankle PC
• Keisa Christine Desouza, LVN
• Dewey D Pillai, MD, Inc
• Holland Fennell Dewit
• Partiksha Dhanda, FNP-C
• Reinante Diamante, RN
• Diane Boval DDS a Professional Dental Corp (Gold Coast Dental)

• Family Nurse Practitioner in Santa Clarita, CA
• Providers in Santa Clarita, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; 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.