ALISSA ANNE DETZ MD
NPI 1811211626
Internal Medicine in Los Angeles, CA
About Alissa Anne Detz Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ALISSA ANNE DETZ MD (NPI 1811211626) is an individual internal medicine provider in Los Angeles, California, licensed in California (A110966) and active in the NPI registry since March 2010. She is enrolled in Medicare PECOS and is a graduate of University Of California, Irvine, California College Of Medicine (2008).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Alissa Anne Detz Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Alissa Detz reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
San Rafael, CA 94901
- Reassigned Medicare billing, California enrollment
- 17 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 90095 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.
LOS ANGELES, CA 90095
LOS ANGELES, CA 90095
LOS ANGELES, CA 90095
LOS ANGELES, CA 90095
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 Alissa Detz's NPI number?
The NPI number for Alissa Detz is 1811211626. It was assigned to this individual provider in the NPPES registry on March 23, 2010.
Where is Alissa Detz located?
Alissa Detz practices at 200 Medical Plz 420, Los Angeles, CA 90095. The listed phone number is (310) 794-9809.
What is Alissa Detz's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Alissa Detz enrolled in Medicare?
Yes. Alissa Detz is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Alissa Detz's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Alissa Detz reassigns Medicare benefits to Marin Community Clinic (San Rafael, CA). The 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 Alissa Detz's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Alissa Detz was last updated on August 31, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Alissa Anne Detz, MD · NPI 1811211626
Internal Medicine physician in Los Angeles, California. Individual provider, active in the CMS NPPES registry since March 23, 2010.
## Identity
- **NPI:** 1811211626 (Entity type: Individual)
- **Enumerated:** March 23, 2010
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **State license:** A110966 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 200 MEDICAL PLZ, 420, Los Angeles, CA 90095-0001
- **Phone:** (310) 794-9809 · **Fax:** (310) 206-3551
## 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:** Marin Community Clinic (NPI 1154503399, San Rafael, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of California, Irvine, California College Of Medicine, class of 2008
## Record status
- **NPPES last updated:** August 31, 2012
- **Other identifiers:** Medicare PIN FF032Y (CA); Other 1811211626 (CA); Medicaid 1811211626 (CA)
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Source: [NPI Profile](https://npiprofile.com/npi/1811211626) · Data from the CMS NPPES public registry.