Individual provider Active NPI

Anthony Ogbodo

  • Family Nurse Practitioner
  • Tracy, CA
National Provider Identifier
1063884625
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95002864 Issued in CA
Practice address
2471 North Naglee Road
Suite 100 #1037
Tracy, CA 95304-3519
Phone
(510) 755-3004
NPI assigned
Oct 22, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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 95002864 CA Primary

Addresses

Primary practice location

2471 North Naglee Road
Suite 100 #1037
Tracy, CA 95304-3519

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (888) 663-6331

Other practice location 1

2 Embarcadero Ctr
San Francisco, CA 94111-3823
Phone (888) 663-6331

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
I20200909002290 CA Practitioner - Nurse Practitioner 5092079616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1409 N Tracy Blvd
Tracy, CA 95376-3445
Phone (209) 509-4116

8801 Ranch Rd
Tracy, CA 95304-8116
Phone (209) 509-4116

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
79645CAMDPharmacist
95002864CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tri Valley Care Telehealth & Telemedicine Inc Family CurrentSince May 26, 2025 Accepting new patients

Locations

2471 Naglee Rd
Ste 100
Tracy, CA 95304
Phone (209) 509-4116

1409 N Tracy Blvd
Tracy, CA 95376
Phone (209) 509-4116

Interoperability endpoints

  • Direct secure messaging: anthony.ogbodo.p1@direct.cmcentersinc.nextgenshare.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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1445472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1063884625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "888-663-6331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2471 NORTH NAGLEE ROAD",
            "address_2": "SUITE 100 #1037",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953043519",
            "telephone_number": "510-755-3004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Embarcadero Ctr",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941113823",
            "country_code": "US",
            "telephone_number": "888-663-6331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OGBODO",
        "first_name": "ANTHONY",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-22",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95002864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tracy, CA

Sources for this page

Verify at the official NPI Registry.