Ms Adaljiza Tavera, PMHNP, FNP - Medicare Nurse Practitioner in Gardena, CA

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Ms Adaljiza Tavera, PMHNP, FNP is a medicare enrolled "Nurse Practitioner - Family" in Gardena, California. She graduated from nursing school in 2020 and has 4 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Ehab Yacoub Md Inc and her current practice location is 1225 W 190th St Ste 280, Gardena, California. You can reach out to her office (for appointments etc.) via phone at (310) 515-8113.

Ms Adaljiza Tavera is licensed to practice in California (license number NP95013634) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1043825193.

Contact Information

Ms Adaljiza Tavera, PMHNP, FNP
1225 W 190th St Ste 280,
Gardena, CA 90248-4305
(310) 515-8113
(310) 538-2102

Map and Direction




Provider's Profile

Full NameMs Adaljiza Tavera
GenderFemale
SpecialityNurse Practitioner
Experience4 Years
Location1225 W 190th St Ste 280, Gardena, California
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Ms Adaljiza Tavera graduated from nursing school in 2020
  NPI Data:
  • NPI Number: 1043825193
  • Provider Enumeration Date: 09/14/2020
  • Last Update Date: 09/14/2020
  Medicare PECOS Information:
  • PECOS PAC ID: 9537575337
  • Enrollment ID: I20210302002174

Medical Identifiers

Medical identifiers for Ms Adaljiza Tavera such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1043825193NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family NP95013634 (California)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Ehab Yacoub Md Inc509209952388

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ms Adaljiza Tavera allows following entities to bill medicare on her behalf.
Entity NameEhab Yacoub Md Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1417373713
PECOS PAC ID: 5092099523
Enrollment ID: O20170301002071

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Adaljiza Tavera is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Ms Adaljiza Tavera, PMHNP, FNP
Po Box 31231,
Los Angeles, CA 90031-0231

Ph: (323) 947-4901		Ms Adaljiza Tavera, PMHNP, FNP
1225 W 190th St Ste 280,
Gardena, CA 90248-4305

Ph: (310) 515-8113

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.