Individual provider Active NPI

Ritah W Waweru, NP-C

  • Family Nurse Practitioner
  • Turlock, CA
National Provider Identifier
1285357897
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95022660 Issued in CA
Practice address
1060 Delbon Ave.
Turlock, CA 95382-9538
Phone
(209) 813-8913
Fax
(209) 251-0611
NPI assigned
Sep 20, 2022
Last updated
Oct 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95022660 CA Primary

Addresses

Primary practice location

1060 Delbon Ave.
Turlock, CA 95382-9538

Mailing address

2420 Boston Way
Modesto, CA 95355-8946
Phone (209) 300-4039

Other names 1

  • Ritah W Rose Other name

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
I20260608003630 CA Practitioner - Nurse Practitioner 8426529645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dazzle Health P CGroup PAC ID 4082146634, 26 clinicians

Practice addresses (Care Compare)

18650 Macarthur Blvd
Irvine, CA 92612-1244
Phone (412) 996-9012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95022660CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emanuel Medical Center, Inc. PastSince Oct 29, 2023 Accepting new patients
Sara Hamidi MD Inc. PastSince Oct 29, 2023 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1663632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1285357897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 BOSTON WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953558946",
            "telephone_number": "209-300-4039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 DELBON AVE.",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953829538",
            "telephone_number": "209-813-8913",
            "fax_number": "209-251-0611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAWERU",
        "first_name": "RITAH",
        "middle_name": "W",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-20",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95022660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RITAH",
            "last_name": "ROSE",
            "middle_name": "W",
            "credential": "APRN-FNP-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Turlock, CA

Sources for this page

Verify at the official NPI Registry.