Individual provider Active NPI

Chetra Mech Seng

  • Family Nurse Practitioner
  • Montclair, CA
National Provider Identifier
1821753732
Registry record updated Nov 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95018671 Issued in CA
Practice address
5039 Rosewood St
Montclair, CA 91763-2840
Phone
(909) 277-0742
NPI assigned
Nov 4, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2021

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 95018671 CA Primary

Addresses

Primary practice location

5039 Rosewood St
Montclair, CA 91763-2840

Mailing address

5039 Rosewood St
Montclair, CA 91763-2840
Phone (909) 277-0742

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
I20240227004256 CA Practitioner - Nurse Practitioner 4183069388 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95018671CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Medical Group, Inc. CurrentSince Dec 30, 2023 Accepting new patients

Locations

275 N El Cielo Rd
Palm Springs, CA 92262
Phone (760) 320-8814

Interoperability endpoints

  • Direct secure messaging: chetra.seng.p4@direct.regal.nextgenshare.com
  • Direct secure messaging: chetra.seng.p2@direct.mydohc.nextgenshare.com

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": "1635984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1821753732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5039 ROSEWOOD ST",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917632840",
            "telephone_number": "909-277-0742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5039 ROSEWOOD ST",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917632840",
            "telephone_number": "909-277-0742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SENG",
        "first_name": "CHETRA",
        "middle_name": "MECH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-04",
        "last_updated": "2021-11-04",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95018671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, CA

Sources for this page

Verify at the official NPI Registry.