Individual provider Active NPI

Omoshola Anthony Egbesemi

  • Non-emergency Medical Transport (VAN)
  • Bakersfield, CA
National Provider Identifier
1063002863
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
Practice address
11007 Vista del Luna Dr
Bakersfield, CA 93311-9182
Phone
(661) 852-1278
NPI assigned
Jan 25, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X CA Primary

Addresses

Primary practice location

11007 Vista del Luna Dr
Bakersfield, CA 93311-9182

Mailing address

11007 Vista del Luna Dr
Bakersfield, CA 93311-9182
Phone (661) 852-1278

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Non Emergency Medical Transportation Non-Emergency Medical Transport (Van) CurrentSince Aug 1, 2021 Accepting new patients

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": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1063002863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11007 VISTA DEL LUNA DR",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933119182",
            "telephone_number": "661-852-1278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11007 VISTA DEL LUNA DR",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933119182",
            "telephone_number": "661-852-1278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGBESEMI",
        "first_name": "OMOSHOLA",
        "middle_name": "ANTHONY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-25",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.