Benedicta Ofunne Omoko, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

9274284 Issued in CA

Practice address

1115 S Sunset Ave
West Covina, CA 91790-3940

Phone

(626) 962-4011

NPI assigned

Jul 17, 2018

Last updated

Jul 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Benedicta Ofunne Okiwelu Former name

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Valley Community Health Center, Inc.Group PAC ID 9234041765, 50 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: benedicta.omoko.p1@direct.evchc.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• East Valley Community Health Center, Inc.

  dba East Valley Community Health Center

  • Federally Qualified Health Center (FQHC)
  • West Covina, CA
  • NPI 1831243625
  Medicare reassignment Care Compare group NPD
• East Valley Community Health Center, Inc.

  dba East Valley Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Pomona, CA
  • NPI 1649324443
  NPD

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

{
    "created_epoch": "1531785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531785600000",
    "number": "1154807642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 S SUNSET AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903940",
            "telephone_number": "626-962-4011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 S SUNSET AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903940",
            "telephone_number": "626-962-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMOKO",
        "first_name": "BENEDICTA",
        "middle_name": "OFUNNE",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-17",
        "last_updated": "2018-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "9274284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BENEDICTA",
            "last_name": "OKIWELU",
            "middle_name": "OFUNNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christina Olmos
• Cynthia Olvera
• Jennifer Olvera
• Akbar Omar, M.D.
• Keann Ombao
• Danilene Dianne Sison Ong, NP-BC
• Lilian Shaw Ong, DDS
• Onsyte Imaging Inc
• Beladona Ontiveros
• Onyx Pain Management Medical Corporation

• Family Medicine Physician in West Covina, CA
• Providers in West Covina, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2018; 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.