Meredith Dettmar, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

10787 Laurel St
Rancho Cucamonga, CA 91730-3828

Phone

(099) 982-7741

NPI assigned

Sep 19, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Meredith Einspahr Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Cep America - California

  • Emergency Medicine Physician
  • Santa Ana, CA
  • NPI 1548667843
  Medicare reassignment
• Chaparral Medical Group, Inc.

  • Orthopaedic Surgery Physician
  • Pomona, CA
  • NPI 1477733624
  Medicare reassignment
• John a Fagan MD Family Practice Inc

  • Primary Care Clinic/Center
  • Rancho Cucamonga, CA
  • NPI 1417130881
  Medicare reassignment
• Cep America - California

  • Emergency Medicine Physician
  • Pomona, CA
  • NPI 1740235258
  NPD
• Chaparral Medical Group Inc.

  • Cardiovascular Disease Physician
  • Upland, CA
  • NPI 1639869605
  NPD
• Chaparral Medical Group, Inc.

  • Internal Medicine Physician
  • Pomona, CA
  • NPI 1902111024
  NPD
• Pomona Valley Hospital Medical Center

  • General Acute Care Hospital
  • Pomona, CA
  • NPI 1518067586
  NPD (past)

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

{
    "created_epoch": "1442620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1902275993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16705 CAROB AVE",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917096524",
            "telephone_number": "909-816-4256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10787 LAUREL ST",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303828",
            "telephone_number": "099-982-7741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETTMAR",
        "first_name": "MEREDITH",
        "credential": "P.A.-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-19",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "52882",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEREDITH",
            "last_name": "EINSPAHR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Riya Desai
• Brandi Lonje Deshannon
• James Phillip Desilva
• Eden D Desta
• Marie Veronica Dethomas, NP
• Christopher Robin Deulen, PH.D
• Devine Counseling
• Elizabeth Dewitt
• Sharon Dey-Layne, CNS
• Brittany Wanland Dey, PSYD

• Physician Assistant in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.