Individual provider Active NPI

Awisa Monsefan Hodge, RN, MSN, NP-C

  • Family Nurse Practitioner
  • Danville, CA
National Provider Identifier
1013071547
Registry record updated Feb 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
16647 Issued in CA
Practice address
4165 Blackhawk Plaza Cir 100
Danville, CA 94506-4691
Phone
(925) 736-7070
Fax
(925) 736-7075
NPI assigned
Dec 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 16647 CA Primary

Addresses

Primary practice location

4165 Blackhawk Plaza Cir 100
Danville, CA 94506-4691

Mailing address

4165 Blackhawk Plaza Cir 100
Danville, CA 94506-4691
Phone (925) 736-7070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110505000631 CA Practitioner - Nurse Practitioner 6608051602 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
16647CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bass Medical Group Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: amonsefan47167@ehr.johnmuirhealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738886400000",
    "number": "1013071547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4165 BLACKHAWK PLAZA CIR 100",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945064691",
            "telephone_number": "925-736-7070",
            "fax_number": "925-736-7075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4165 BLACKHAWK PLAZA CIR 100",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945064691",
            "telephone_number": "925-736-7070",
            "fax_number": "925-736-7075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGE",
        "first_name": "AWISA",
        "middle_name": "MONSEFAN",
        "name_prefix": "Miss",
        "credential": "RN, MSN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "16647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, CA

Sources for this page

Verify at the official NPI Registry.