Individual provider Active NPI

Nestor Devesi, MBBS

  • Pediatrics Physician
  • Pago Pago, AS
National Provider Identifier
1891431748
Registry record updated May 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2226C Issued in AS
Practice address
11155 Turner Drive
Pago Pago, AS 96799-0010
Phone
(684) 633-1222
Fax
(684) 633-1869
NPI assigned
May 12, 2022
Last updated
May 12, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2226C AS Primary

Addresses

Primary practice location

11155 Turner Drive
Pago Pago, AS 96799-0010

Mailing address

PO Box LBJ
Pago Pago, AS 96799-0010
Phone (684) 633-1222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AS
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240123003301 AS Practitioner - Pediatric Medicine 0648622977 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2226CASMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Samoa Medical Center CurrentSince Nov 27, 2023 Accepting new patients

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, 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": "1652313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652313600000",
    "number": "1891431748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX LBJ",
            "city": "PAGO PAGO",
            "state": "AS",
            "postal_code": "967990010",
            "telephone_number": "684-633-1222",
            "fax_number": "684-633-1869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11155 TURNER DRIVE",
            "city": "PAGO PAGO",
            "state": "AS",
            "postal_code": "967990010",
            "telephone_number": "684-633-1222",
            "fax_number": "684-633-1869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVESI",
        "first_name": "NESTOR",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-12",
        "last_updated": "2022-05-12",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AS",
            "license": "2226C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pago Pago, AS

Sources for this page

Verify at the official NPI Registry.