Individual provider Active NPI

Ihuoma Maria Agada

  • Family Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1295569044
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95023344 Issued in CA
Practice address
10300 Compton Ave
Los Angeles, CA 90002-3628
Phone
(213) 361-4487
NPI assigned
Aug 26, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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 95023344 CA Primary

Addresses

Primary practice location

10300 Compton Ave
Los Angeles, CA 90002-3628

Mailing address

10300 Compton Ave
Los Angeles, CA 90002-3628
Phone (310) 989-1674

Other identifiers 1

IdentifierTypeStateIssuer
1295569044OtherCA01

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
I20250620000810 CA Order and Referring Only - Nurse Practitioner 3678085214

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95023344CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1724630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1295569044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10300 COMPTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900023628",
            "telephone_number": "310-989-1674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 COMPTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900023628",
            "telephone_number": "213-361-4487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGADA",
        "first_name": "IHUOMA",
        "middle_name": "MARIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-26",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95023344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "01",
            "identifier": "1295569044",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.