DR. MESFIN GEBREEGZIABHER DESTA
NPI 1104784792
Family Medicine in Tacoma, WA
About Dr. Mesfin Gebreegziabher Desta NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. MESFIN GEBREEGZIABHER DESTA (NPI 1104784792) is an individual family medicine provider in Tacoma, Washington, licensed in Washington (MDCE.ML.70087335) and active in the NPI registry since January 2026. He is enrolled in Medicare PECOS, is affiliated with Olympic Medical Center, and is a graduate of Other (1995).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Mesfin Gebreegziabher Desta is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Mesfin Desta reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Tacoma, WA 98409
- Reassigned Medicare billing, Washington enrollment
- 55 clinicians in this Medicare group
Elma, WA 98541
- Reassigned Medicare billing, Washington enrollment
- 64 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Olympic Medical Center
Acute Care Hospitals · Port Angeles, WAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 98402 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
TACOMA, WA 98402
TACOMA, WA 98402
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 Mesfin Desta's NPI number?
The NPI number for Mesfin Desta is 1104784792. It was assigned to this individual provider in the NPPES registry on January 12, 2026.
Where is Mesfin Desta located?
Mesfin Desta practices at 917 Pacific Ave Ste 600, Tacoma, WA 98402. The listed phone number is (253) 844-4327.
What is Mesfin Desta's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Mesfin Desta enrolled in Medicare?
Yes. Mesfin Desta is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Mesfin Desta's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mesfin Desta reassigns Medicare benefits to 2 organizations: Platinum Peaks Healthcare PC (Tacoma, WA) and Pacific Medical Specialty Group (Elma, WA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mesfin Desta's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Mesfin Desta affiliated with any hospitals?
According to CMS data, Mesfin Desta is affiliated with Olympic Medical Center.
When was this NPI record last updated?
The NPPES record for Mesfin Desta was last updated on February 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.
# Dr. Mesfin Gebreegziabher Desta · NPI 1104784792
Family Medicine physician in Tacoma, Washington. Individual provider, active in the CMS NPPES registry since January 12, 2026.
## Identity
- **NPI:** 1104784792 (Entity type: Individual)
- **Enumerated:** January 12, 2026
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** MDCE.ML.70087335 (Washington)
- **Sole proprietor:** No
## Practice location
- **Address:** 917 PACIFIC AVE STE 600, Tacoma, WA 98402-4437
- **Phone:** (253) 844-4327
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Platinum Peaks Healthcare PC (NPI 1821982893, Tacoma, WA); Pacific Medical Specialty Group (NPI 1548911811, Elma, WA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1995
## Record status
- **NPPES last updated:** February 14, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1104784792) · Data from the CMS NPPES public registry.