NPIMap

Individual provider Active NPI

Nnenna I Nwogu, M.D.

  • Internal Medicine Physician
  • Emeryville, CA
National Provider Identifier
1255711461
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A167615 Issued in CA
Practice address
5800 Hollis St
Emeryville, CA 94608-2016
Phone
(510) 806-2100
NPI assigned
Jun 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 294294 NY
Internal Medicine Physician 207R00000X A167615 CA Primary

Addresses

Primary practice location

5800 Hollis St
Emeryville, CA 94608-2016

Mailing address

5800 Hollis St
Emeryville, CA 94608-2016
Phone (510) 806-2100

Other practice location 1

550 1st Ave
New York, NY 10016
Phone (212) 263-5506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220406001151 CA Practitioner - Internal Medicine 0345599668 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Healthcare AllianceGroup PAC ID 6305748799, 334 clinicians

Practice addresses (Care Compare)

1300 Crane St
Menlo Park, CA 94025-4260
Phone (650) 498-6500

4725 1St St
Suite 100
Pleasanton, CA 94566-7366
Phone (925) 462-7060

6121 Hollis St
Emeryville, CA 94608-2077

Hospital & facility affiliations

  • BLC Homehealth Inc Home health agency, San Leandro, CA, CCN 053137
  • Healthflex Home Health Services Home health agency, Oakland, CA, CCN 059551
  • Stanford Health Care Hospital, Stanford, CA, CCN 050441
  • Alta Bates Summit Medical Center Hospital, Oakland, CA, CCN 050043
  • Alta Bates Summit Medical Center - Alta Bates Camp Hospital, Berkeley, CA, CCN 050305
  • Stanford Health Care Tri-Valley Hospital, Pleasanton, CA, CCN 050283
  • California Pacific Medical Center- Van Ness Campus Hospital, San Francisco, CA, CCN 050047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A167615CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stanford Health Care CurrentSince Mar 30, 2022 Accepting new patients
University Healthcare Alliance Internal Medicine CurrentSince Mar 30, 2022 Accepting new patients
Stanford Health Care CurrentSince Mar 30, 2022 Accepting new patients
Stanford Health Care Internal Medicine Current Accepting new patients
Maimonides Medical Center Current Accepting new patients
Affinity Medical Group Past Accepting new patients

Locations

50 E Hamilton Ave
Ste 280
Campbell, CA 95008
Phone (408) 227-2646

6121 Hollis St
Ste 400
Emeryville, CA 94608
Phone (510) 266-5400

5800 Hollis St
Emeryville, CA 94608
Phone (510) 806-2100

1300 Crane St
Menlo Park, CA 94025
Phone (510) 785-5000

4725 1st St
Ste 100
Pleasanton, CA 94566
Phone (925) 462-7060

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

Interoperability endpoints

  • Direct secure messaging: nnennanwogu@mai.allscriptsdirect.net
  • Direct secure messaging: nnwogu355523@direct.stanfordhealthcare.org

Organizations & group practices 6

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1255711461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 HOLLIS ST",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946082016",
            "telephone_number": "510-806-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 HOLLIS ST",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946082016",
            "telephone_number": "510-806-2100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 1st Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10016",
            "country_code": "US",
            "telephone_number": "212-263-5506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NWOGU",
        "first_name": "NNENNA",
        "middle_name": "I",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-02",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "294294",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A167615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Emeryville, CA

Sources for this page

Verify at the official NPI Registry.