Maryjane Duromola

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95029802 Issued in CA

Practice address

200 Oceangate Ste 100
Long Beach, CA 90802-4317

Phone

(909) 361-9913

NPI assigned

May 2, 2024

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

Other names 1

• Abosede Mary Raji 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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Central Health Plan of California, Inc.

  • Health Maintenance Organization
  • Diamond Bar, CA
  • NPI 1386714772
  Medicare reassignment NPD
• Molina Healthcare of California

  • Health Maintenance Organization
  • Long Beach, CA
  • NPI 1194811760
  Medicare reassignment NPD
• Universal Care

  • Pediatrics Physician
  • Long Beach, CA
  • NPI 1376632877
  NPD

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

{
    "created_epoch": "1714608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718496000000",
    "number": "1235986647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 E DATE PALM PASEO APT 2226",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917644672",
            "telephone_number": "626-479-6482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 OCEANGATE STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024317",
            "telephone_number": "909-361-9913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUROMOLA",
        "first_name": "MARYJANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-02",
        "last_updated": "2024-06-16",
        "certification_date": "2024-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95029802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABOSEDE",
            "last_name": "RAJI",
            "middle_name": "MARY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cynthia Durazo
• Heather Elizabeth Durbin-Mibeck
• Virginia Lillian Durivage, LCSW
• Charles William Durnin
• Ferdinand Benito Durol
• Joanna Duron, FNP
• Stephanie Lorraine Duron, R.N.
• Joseph Thomas Duross, DDS
• Elizabeth Durow
• Chika Ebenezer Duru

• Family Nurse Practitioner in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2024; 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.

Verify at the official NPI Registry.