Individual provider Active NPI

Mariam Ihuomakanwa Garuba, M.D.

  • Psychiatry Physician
  • Pomona, CA
National Provider Identifier
1275748261
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
C172191 Issued in CA
Practice address
2008 N Garey Ave
Pomona, CA 91767-2722
Phone
(718) 245-2310
NPI assigned
May 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 25MA09789600 NJ
Psychiatry Physician 2084P0800X 106867 AK
Psychiatry Physician 2084P0800X D0090775 MD
Psychiatry Physician 2084P0800X 268153 NY
Psychiatry Physician 2084P0800X C172191 CA Primary

Addresses

Primary practice location

2008 N Garey Ave
Pomona, CA 91767-2722

Mailing address

35 Journal Square Plaza
# 486
Jersey City, NJ 07306-2054
Phone (862) 902-9798

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ, AK, VI, CA, NE6 enrollments
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 6

Enrollment IDStateProvider typePAC IDDetails
I20161114000512 NY Practitioner - Psychiatry 1759536576 Reassigns benefits to 1 organization
I20180710000211 NJ Practitioner - Psychiatry 1759536576 Reassigns benefits to 2 organizations
I20190221001099 AK Practitioner - Psychiatry 1759536576 Reassigns benefits to 1 organization
I20210630000076 VI Practitioner - Psychiatry 1759536576 Reassigns benefits to 1 organization
I20210715003651 CA Practitioner - Psychiatry 1759536576 Reassigns benefits to 2 organizations
I20250417002416 NE Practitioner - Psychiatry 1759536576 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Creighton University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Regis Mohawk TribeGroup PAC ID 5799748547, 11 clinicians

Practice addresses (Care Compare)

404 State Route 37
Akwesasne, NY 13655-3109
Phone (518) 358-3141

412 State Route 37
Hogansburg, NY 13655-3109
Phone (518) 358-3141

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
106867AKMDPsychiatry Physician
C172191CAMDPsychiatry Physician
D0090775MDMDPsychiatry Physician
25MA09789600NJMDPsychiatry Physician
268153NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mat Su Valley Medical Center LLC Current Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Oct 17, 2016 Accepting new patients
New York City Health and Hospitals Corporation Current Accepting new patients
Consolidated Care LLC CurrentSince May 27, 2018 Accepting new patients
Omaha Insomnia and Psychiatric Services, LLC Psychiatry CurrentSince Feb 19, 2025 Accepting new patients
Practice Associates Medical Group CurrentSince May 6, 2022 Accepting new patients
Mat-Su Valley Medical Center LLC CurrentSince May 20, 2020 Accepting new patients
County of Monterey Behavioral Health CurrentSince Nov 12, 2025 Accepting new patients
Omaha Insomnia and Psychiatric Services, LLC Psychiatry CurrentSince Feb 19, 2025 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Oct 17, 2016 Accepting new patients
Tri-City Mental Health Authority CurrentSince Mar 17, 2025 Accepting new patients
Tri-City Mental Health Center PastSince Mar 17, 2025 Accepting new patients

Locations

950 E Bogard Rd
Wasilla, AK 99654
Phone (907) 352-2880

2008 N Garey Ave
Pomona, CA 91767
Phone (909) 242-7640

13917 Gold Cir
Omaha, NE 68144
Phone (402) 991-9630

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

410 Chancellor Ave
Newark, NJ 07112
Phone (862) 246-7899

451 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 245-3131

227 Madison St
New York, NY 10002
Phone (212) 238-7000

50 Water St
Fl 3
New York, NY 10004

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1275748261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 JOURNAL SQUARE PLAZA",
            "address_2": "# 486",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073062054",
            "telephone_number": "862-902-9798",
            "fax_number": "731-225-8250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2008 N GAREY AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917672722",
            "telephone_number": "718-245-2310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARUBA",
        "first_name": "MARIAM",
        "middle_name": "IHUOMAKANWA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA09789600",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AK",
            "license": "106867",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D0090775",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "268153",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C172191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.