Individual provider Active NPI

Femi Benaiah Obanor, FNP-BC

  • Family Nurse Practitioner
  • Fresno, CA
National Provider Identifier
1225547359
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95008046 Issued in CA
Practice address
3795 E Shields Ave
Fresno, CA 93726-7029
Phone
(404) 704-5891
NPI assigned
Sep 20, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN219594 GA
Family Nurse Practitioner 363LF0000X 95008046 CA Primary

Addresses

Primary practice location

3795 E Shields Ave
Fresno, CA 93726-7029

Mailing address

3795 E Shields Ave
Fresno, CA 93726-7029
Phone (404) 704-5891

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
I20180228002877 CA Practitioner - Nurse Practitioner 0547521809 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pain Clinics of Central California, Inc. 19 clinicians

Practice addresses (Care Compare)

3751 E Shields Ave
Fresno, CA 93726-7029
Phone (833) 478-1818

Hospital & facility affiliations

  • San Joaquin Valley Rehabilitation Hosp Inpatient rehabilitation facility, Fresno, CA, CCN 053032

Merit-based Incentive Payment System (MIPS)

Final score
22.29 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
74.29

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95008046CAMDFamily Nurse Practitioner
RN219594GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Clinics of Central California, Inc. Pain Medicine CurrentSince May 20, 2022 Accepting new patients
Regenerative Spine, Pain, and Neuropathy Centers, Inc. PastSince Jun 22, 2021 Accepting new patients
Lags Spine and Sportscare Medical Centers, Inc. Past Accepting new patients
Lags Spine and Sportscare Medical Centers Inc Past Accepting new patients

Locations

4605 Buena Vista Rd
Ste 600815
Bakersfield, CA 93311

5771 N Fresno St
Ste 101
Fresno, CA 93710
Phone (559) 272-1295

3751 E Shields Ave
Fresno, CA 93726
Phone (559) 272-1295

3793 E Shields Ave
Fresno, CA 93726
Phone (833) 478-1818

1130 Coffee Rd
Bldg 5B
Modesto, CA 95355
Phone (833) 478-1818

1317 Oakdale Rd
Ste 800
Modesto, CA 95355
Phone (209) 284-0729

1801 Tully Rd
Ste F
Modesto, CA 95350
Phone (209) 526-5770

4505 Precissi Ln
Ste A
Stockton, CA 95207
Phone (209) 425-3815

2350 W Whitendale Ave
Visalia, CA 93277
Phone (559) 625-5286

Organizations & group practices 4

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": "1505865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1225547359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3795 E SHIELDS AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937267029",
            "telephone_number": "404-704-5891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3795 E SHIELDS AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937267029",
            "telephone_number": "404-704-5891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBANOR",
        "first_name": "FEMI",
        "middle_name": "BENAIAH",
        "name_prefix": "Mr.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-20",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN219594",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95008046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.