Theresa Nkechinyerem Okeke, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA57663 Issued in CA

Practice address

5931 Wilshire Dr
Fontana, CA 92336-5697

Phone

(619) 452-5397

NPI assigned

Feb 7, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Exer Medical CorporationGroup PAC ID 9032359534, 336 clinicians

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: theresa.okeke.p2@direct.hvvmg.nextgenshare.com
• Direct secure messaging: tokeke1374567@oc.providencedirect.org
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Exer Medical Corporation

  • Urgent Care Clinic/Center
  • Calabasas, CA
  • NPI 1588901532
  Medicare reassignment Care Compare group
• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group
• Vvipa Medical Group Inc

  • Clinic/Center
  • Victorville, CA
  • NPI 1295126001
  Medicare reassignment NPD
• Ghods Inc

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1790344869
  Medicare reassignment
• Optimum Wound Care Inc

  • Surgery Physician
  • Woodland Hills, CA
  • NPI 1578217451
  Medicare reassignment
• Physicians and Surgeons Home Care Inc

  • Surgery Physician
  • Los Angeles, CA
  • NPI 1184105231
  Medicare reassignment
• High Desert Medical Group

  • Multi-Specialty Clinic/Center
  • Lancaster, CA
  • NPI 1720196702
  NPD
• Providence Medical Foundation

  • Urology Physician
  • Apple Valley, CA
  • NPI 1053616706
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD

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

{
    "created_epoch": "1581033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1114559176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5931 WILSHIRE DR",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923365697",
            "telephone_number": "619-452-5397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5931 WILSHIRE DR",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923365697",
            "telephone_number": "619-452-5397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKEKE",
        "first_name": "THERESA",
        "middle_name": "NKECHINYEREM",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-07",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA57663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "urgentcaresmhd@sjhhandhmg.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "12550 Hesperia Rd Ste 101",
            "city": "Victorville",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923955873",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Edward Ungseok Oh, MD
• Stellamaris Ohakamnu, DO
• Jeanette Ojeda
• Ojg Inc
• Isioma Tracy Okafor, LVN
• Elizabeth Ibitoru Oketola, DME PROVIDER
• Cynthia E Okoeguale, PMHNP
• Nnennaya Ogbulorie Okoronkwo, PMHNP
• Leland M. Okubo, MD
• Blessing Chinyere Okwara, RN

• Physician Assistant in Fontana, CA
• Providers in Fontana, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; 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.

Verify at the official NPI Registry.