Individual provider Active NPI

Dinah Elmesewdy

  • Acute Care Nurse Practitioner
  • Lodi, CA
National Provider Identifier
1780915678
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
19445 Issued in CA
Practice address
975 S Fairmont Ave
Lodi, CA 95240-5118
Phone
(209) 334-3411
NPI assigned
Jan 17, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 19445 CA Primary

Addresses

Primary practice location

975 S Fairmont Ave
Lodi, CA 95240-5118

Mailing address

156 Parnassus Ave
Apt 6
San Francisco, CA 94117-4252
Phone (415) 566-6694

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

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
I20100719000364 CA Practitioner - Nurse Practitioner 8820120363 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19445CAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco Current Accepting new patients

Locations

400 Parnassus Ave
#300
San Francisco, CA 94143
Phone (415) 476-2163

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

Interoperability endpoints

  • Direct secure messaging: delmesewdy27965@direct-ucsfmedicalcenter.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1263686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1780915678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 PARNASSUS AVE",
            "address_2": "APT 6",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941174252",
            "telephone_number": "415-566-6694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 S FAIRMONT AVE",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952405118",
            "telephone_number": "209-334-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELMESEWDY",
        "first_name": "DINAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-17",
        "last_updated": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "19445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1600 Owens St",
            "city": "San Francisco",
            "state": "CA",
            "country_code": "US",
            "postal_code": "94158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lodi, CA

Sources for this page

Verify at the official NPI Registry.