Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ellen Marie Dejong, MD

Individual provider Pediatrics Physician · NPI 1154711836

Ellen Marie Dejong, MD is a Pediatric Medicine in Truckee, California. Qualified in 2016, 10 years ago. Practices with Tahoe Forest Hospital District, a 142-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
10
Licensed in
CA
In the registry since
2015
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

10121 Pine Ave
Truckee, CA 96161-4856
Phone: (510) 307-6773
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence A151834 (CA)
Pediatrics Physician Taxonomy 208000000X · Licence A151834 (CA)

Record details

NPI number1154711836
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedFebruary 2, 2015
Last updated in NPPESJune 8, 2023
Certification dateJune 8, 2023
Mailing address10 Arch St Apt 204, Redwood City, CA 94062-1402

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPEDIATRIC MEDICINE
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Tahoe Forest Hospital District — 142 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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