Active NPI
Ikechukwu Anele Ohiaeri, M.D.
- Psychiatry Physician
- Victorville, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A51835
- Practice address
- 14344 Cajon St.
Suite 102
Victorville, CA 92392-4301 - Phone
- (760) 843-0506
- NPI assigned
- Aug 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A51835 | CA | Primary |
Addresses
Primary practice location
14344 Cajon St.
Suite 102
Victorville, CA 92392-4301
Mailing address
14344 Cajon St.
Suite 102
Victorville, CA 92392-4301
Phone (760) 843-0506
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A518353 | Medicaid | CA |
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Other, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
15434 W Sage St
Suite 101
Victorville, CA 92392-9708
Phone (760) 843-0506
Hospital & facility affiliations
- Victor Valley Global Medical Center
- Providence St Mary Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A51835 | CA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Conscious Behavioral Health, a Medical Corporation | Psychiatry | Current | Accepting new patients |
| Foothill Behavioral Health Consultants Inc | Psychiatry | Current | Accepting new patients |
| Savanna Olsson, Pmhnp: a Professional Nursing Corporation | Past | Accepting new patients |
Locations
2335 S Towne Ave
Pomona, CA 91766
Phone (760) 843-0506
15434 W Sage St
Victorville, CA 92392
Phone (760) 563-2875
15434 W Sage St
Ste 101
Victorville, CA 92392
Phone (760) 843-0506
16519 Victor St
Ste 406
Victorville, CA 92395
Phone (760) 843-0506
14344 Cajon Ave
Ste 102
Victorville, CA 92392
Phone (760) 243-3999
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Organizations & group practices 3
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.
-
- Psychiatry Physician
- Victorville, CA
- NPI 1265443154
-
- Psychiatry Physician
- Upland, CA
- NPI 1275187346
-
- Nursing Care Agency
- Victorville, CA
- NPI 1942955935
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Apple Valley, CA
- NPI 1669456299
-
- General Acute Care Hospital
- Apple Valley, CA
- NPI 1710109186
-
- General Acute Care Hospital
- Victorville, CA
- NPI 1679879589
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364256000000",
"number": "1063423903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14344 CAJON ST.",
"address_2": "SUITE 102",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923924301",
"telephone_number": "760-843-0506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14344 CAJON ST.",
"address_2": "SUITE 102",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923924301",
"telephone_number": "760-843-0506"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OHIAERI",
"first_name": "IKECHUKWU",
"middle_name": "ANELE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-09",
"last_updated": "2013-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A51835",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A518353",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Victorville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.