Individual provider Active NPI

Gloria Uchechukwu Olekanma

  • Gerontology Nurse Practitioner
  • Riverside, CA
National Provider Identifier
1053028068
Registry record updated Jul 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
95070151 Issued in CA
Practice address
4234 Riverwalk Pkwy Ste 230
Riverside, CA 92505-3312
Phone
(951) 781-3672
NPI assigned
Oct 31, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LG0600X 95070151 CA Primary

Addresses

Primary practice location

4234 Riverwalk Pkwy Ste 230
Riverside, CA 92505-3312

Mailing address

4234 Riverwalk Pkwy Ste 230
Riverside, CA 92505-3312
Phone (951) 781-3672

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
I20260601000273 CA Practitioner - Nurse Practitioner 1557831526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
El-Bershawi Medical CorpGroup PAC ID 9032298492, 44 clinicians

Practice addresses (Care Compare)

4234 Riverwalk Pkwy
Suite 230
Riverside, CA 92505-3312
Phone (951) 781-3672

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95070151CAMDRegistered Nurse

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": "1667174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782950400000",
    "number": "1053028068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4234 RIVERWALK PKWY STE 230",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053312",
            "telephone_number": "951-781-3672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4234 RIVERWALK PKWY STE 230",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053312",
            "telephone_number": "951-781-3672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLEKANMA",
        "first_name": "GLORIA",
        "middle_name": "UCHECHUKWU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-31",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95070151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.