Active NPI
Ogechukwu Paula Odiakosa
- Physician Assistant
- Santa Maria, CA
National Provider Identifier
1174356323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 1075 E Betteravia Rd Ste 201
Santa Maria, CA 93454-7023 - Phone
- (805) 621-7644
- NPI assigned
- Aug 22, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
1075 E Betteravia Rd Ste 201
Santa Maria, CA 93454-7023
Mailing address
1075 E Betteravia Rd Ste 201
Santa Maria, CA 93454-7023
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260413001225 | CA | Order and Referring Only - Physician Assistant | 2961977442 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738022400000",
"number": "1174356323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1075 E BETTERAVIA RD STE 201",
"city": "SANTA MARIA",
"state": "CA",
"postal_code": "934547023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1075 E BETTERAVIA RD STE 201",
"city": "SANTA MARIA",
"state": "CA",
"postal_code": "934547023",
"telephone_number": "805-621-7644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODIAKOSA",
"first_name": "OGECHUKWU",
"middle_name": "PAULA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-08-22",
"last_updated": "2025-01-28",
"certification_date": "2025-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Maria, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.