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MR. MENGESTAB DERI GEBREMESKEL PA-C
NPI 1053407106
Physician Assistant - Medical in Stevenson Ranch, CA

Active since October 05, 2006PECOS Enrolled
25613 CHASE ST, STEVENSON RANCH, CA 91381(310) 268-3890(310) 268-4611 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mr. Mengestab Deri Gebremeskel Pa-c NPPES

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

MR. MENGESTAB DERI GEBREMESKEL PA-C (NPI 1053407106) is an individual medical provider in Stevenson Ranch, California and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053407106
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameMR. MENGESTAB DERI GEBREMESKELCredential: PA-C
Location Address25613 CHASE STStevenson Ranch, CA 91381-1667
Mailing Address25613 Chase StStevenson Ranch, CA 91381-1667 · (310) 268-3890 · Fax (310) 268-4611
Phone(310) 268-3890
Fax(310) 268-4611
Sole ProprietorNo
Enumeration DateOctober 5, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1053407106 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
25613 CHASE ST, Stevenson Ranch, CA 91381
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Mengestab Deri Gebremeskel Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mengestab Gebremeskel's NPI number?

The NPI number for Mengestab Gebremeskel is 1053407106. It was assigned to this individual provider in the NPPES registry on October 5, 2006.

Where is Mengestab Gebremeskel located?

Mengestab Gebremeskel practices at 25613 Chase St, Stevenson Ranch, CA 91381. The listed phone number is (310) 268-3890.

What is Mengestab Gebremeskel's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Mengestab Gebremeskel enrolled in Medicare?

Yes. Mengestab Gebremeskel is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mengestab Gebremeskel was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.