MS. ADALJIZA TAVERA PMHNP, FNP
NPI 1043825193
Nurse Practitioner - Family in Gardena, CA

Q: What is Adaljiza Tavera's NPI number?

The NPI number for Adaljiza Tavera is 1043825193. It was assigned to this individual provider in the NPPES registry on September 14, 2020.

Q: What is Adaljiza Tavera's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Adaljiza Tavera was last updated on September 14, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 14, 2020PECOS EnrolledAccepts Medicare Assignment

1225 W 190TH ST STE 280, GARDENA, CA 90248(310) 515-8113(310) 538-2102 Get Directions Write a Review

NPPES record last updated: September 14, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Ms. Adaljiza Tavera Pmhnp, Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. ADALJIZA TAVERA PMHNP, FNP (NPI 1043825193) is an individual family provider in Gardena, California, licensed in California (NP95013634) and active in the NPI registry since September 2020. She is enrolled in Medicare PECOS, maintains a secondary practice location in Van Nuys, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1043825193

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMS. ADALJIZA TAVERACredential: PMHNP, FNP

Location Address1225 W 190TH ST STE 280Gardena, CA 90248-4305

Mailing AddressPo Box 31231Los Angeles, CA 90031-0231 · (323) 947-4901

Phone(310) 515-8113

Fax(310) 538-2102

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateSeptember 14, 2020

NPPES CertifiedSeptember 11, 2020

✔ NPI 1043825193 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in CA · NP95013634

1225 W 190TH ST STE 280, Gardena, CA 90248

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Secondary Practice Location 1

Location 114541 Delano StVan Nuys, CA 91411-2820 · Phone (310) 515-8113

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Adaljiza Tavera Pmhnp, Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9537575337

PECOS Enrollment IDI20210302002174

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Adaljiza Tavera reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Ehab Yacoub MD Inc.

Same address

Child & Adolescent Psychiatry

1225 W 190TH ST STE 280
Gardena, CA 90248

Reassigned Medicare billing, California enrollment
375 clinicians in this Medicare group

NPI 1417373713 (310) 515-8113

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90248 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JUAN CRISTOBAL RONDEAU MD

Psychiatry & Neurology (Psychiatry)