Individual provider Active NPI

Rahel Asfaw Demessie, NP

  • Family Nurse Practitioner
  • La Jolla, CA
National Provider Identifier
1619749041
Registry record updated Dec 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95027483 Issued in CA
Practice address
8831 Villa la Jolla Dr
La Jolla, CA 92037-1949
Phone
(866) 389-2727
NPI assigned
Oct 30, 2023
Last updated
Dec 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95027483 CA Primary

Addresses

Primary practice location

8831 Villa la Jolla Dr
La Jolla, CA 92037-1949

Mailing address

8831 Villa la Jolla Dr
La Jolla, CA 92037-1949
Phone (866) 389-2727

Other practice location 1

5555 Reservoir Dr
San Diego, CA 92120-5134
Phone (619) 639-7285

Other practice location 2

229 W 7th St
San Jacinto, CA 92583-0417
Phone (951) 487-2550

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
I20231207002058 CA Practitioner - Nurse Practitioner 6901255587 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Omar Osman Practice, LLCGroup PAC ID 4385014042, 45 clinicians
Minuteclinic Diagnostic Medical Group of San Diego IncGroup PAC ID 2567520414, 40 clinicians

Practice addresses (Care Compare)

13101 Hartfield Ave
San Diego, CA 92130-1511
Phone (858) 259-2222

8831 Villa la Jolla Dr
La Jolla, CA 92037-1949
Phone (866) 389-2727

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95027483CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic Medical Group of California Inc Family CurrentSince Jan 13, 2025 Accepting new patients
Minuteclinic Primary Care California Family CurrentSince Jul 16, 2025 Accepting new patients
Minuteclinic Diagnostic Medical Group of Orange County Inc Family CurrentSince Jan 13, 2025 Accepting new patients
Molina Healthcare of California CurrentSince Jun 3, 2024 Accepting new patients
Minuteclinic Diagnostic Medical Group of San Diego Inc Family CurrentSince Jan 13, 2025 Accepting new patients
Omar Osman MD PC CurrentSince Jan 3, 2026 Accepting new patients
Operation Samahan Inc PastSince Jul 22, 2025 Accepting new patients
Nagasamudra S Ashok MD Inc PastSince Nov 1, 2023 Accepting new patients
Nagasamudra S Ashok MD Inc PastSince Nov 1, 2023 Accepting new patients
Operation Samahan, Inc. Past Accepting new patients

Locations

1401 S Baldwin Ave
Arcadia, CA 91007
Phone (626) 321-4210

8850 Valley View St
Buena Park, CA 90620
Phone (714) 827-7321

511 N Hollywood Way
Burbank, CA 91505
Phone (818) 841-0710

2510 El Camino Real
Carlsbad, CA 92008
Phone (760) 729-8941

2760 Fletcher Pkwy
El Cajon, CA 92020
Phone (619) 461-4411

7096 N West Ave
Fresno, CA 93711
Phone (559) 436-0471

14330 Culver Dr
Irvine, CA 92604
Phone (949) 559-8129

8831 Villa La Jolla Dr
La Jolla, CA 92037
Phone (858) 457-4480

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

2456 S Grove Ave
Ontario, CA 91761
Phone (909) 947-9390

11428 Kenyon Way
Rancho Cucamonga, CA 91701
Phone (909) 589-4098

13101 Hartfield Ave
San Diego, CA 92130
Phone (858) 259-2222

5602 University Ave
San Diego, CA 92105
Phone (619) 583-1993

921 Pacific Coast Hwy
Seal Beach, CA 90740
Phone (562) 598-0473

29610 Rancho California Rd
Temecula, CA 92591
Phone (951) 699-0192

33205 US Highway 79
Temecula, CA 92592
Phone 9513033164 ext. 8221

415 W Golf Rd
Ste 26
Arlington Hts, IL 60005

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1698624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734134400000",
    "number": "1619749041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8831 VILLA LA JOLLA DR",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371949",
            "telephone_number": "866-389-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8831 VILLA LA JOLLA DR",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371949",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5555 Reservoir Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921205134",
            "country_code": "US",
            "telephone_number": "619-639-7285",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "229 W 7th St",
            "address_purpose": "LOCATION",
            "city": "San Jacinto",
            "state": "CA",
            "postal_code": "925830417",
            "country_code": "US",
            "telephone_number": "951-487-2550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEMESSIE",
        "first_name": "RAHEL",
        "middle_name": "ASFAW",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-30",
        "last_updated": "2024-12-14",
        "certification_date": "2024-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95027483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.