Individual provider Active NPI

Abigail Anne Cano Deleon

  • Emergency Medicine Physician
  • Tacoma, WA
National Provider Identifier
1609404136
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
011745 Issued in AZ
Practice address
4252 E Roosevelt Ave
Tacoma, WA 98404-4658
Phone
(253) 209-1650
NPI assigned
Mar 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 21845 CA
Internal Medicine Physician 207R00000X XXX WA
Emergency Medicine Physician 207P00000X 011745 AZ Primary

Addresses

Primary practice location

4252 E Roosevelt Ave
Tacoma, WA 98404-4658

Mailing address

4252 E Roosevelt Ave
Tacoma, WA 98404-4658
Phone (253) 209-1650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241209000776 CA Practitioner - Emergency Medicine 1153857602 Reassigns benefits to 2 organizations
I20250909004618 AZ Practitioner - Emergency Medicine 1153857602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America- Arizona, PCGroup PAC ID 1850541970, 89 clinicians
Premier Health PartnersGroup PAC ID 1759564396, 20 clinicians

Practice addresses (Care Compare)

1400 S Dobson Rd
Mesa, AZ 85202-4707
Phone (480) 412-3000

250 N 1St St
Blythe, CA 92225-1702
Phone (760) 921-5123

Hospital & facility affiliations

  • Banner Desert Medical Center Hospital, Mesa, AZ, CCN 030065
  • Palo Verde Hospital Hospital, Blythe, CA, CCN 051339

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21845CAMDAddiction (Substance Use Disorder) Counselor
011745AZMDEmergency Medicine Physician
XXXWAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Arizona PC Emergency Medicine CurrentSince Aug 1, 2025 Accepting new patients
Cep America- Arizona, PC Emergency Medicine Current Accepting new patients
Santa Ana Physicians Group, PC Emergency Medicine CurrentSince Dec 1, 2024 Accepting new patients
Premier Health Partners Emergency Medicine CurrentSince May 16, 2025 Accepting new patients
Cep America-Arizona, PC Emergency Medicine CurrentSince Aug 1, 2025 Accepting new patients

Locations

1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

250 N 1st St
Blythe, CA 92225
Phone (760) 321-5123

47111 Monroe St
Indio, CA 92201
Phone (760) 347-6191

5189 Hospital Rd
Mariposa, CA 95338
Phone (209) 966-3631

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

9449 San Fernando Rd
Sun Valley, CA 91352
Phone (818) 252-2184

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1609404136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4252 E ROOSEVELT AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984044658",
            "telephone_number": "253-209-1650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4252 E ROOSEVELT AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984044658",
            "telephone_number": "253-209-1650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELEON",
        "first_name": "ABIGAIL ANNE",
        "middle_name": "CANO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-30",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "21845",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "XXX",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "011745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.