Aspen Medical Group, Inc

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

ASPEN MEDICAL GROUP, INC

Practice address

9041 Magnolia Ave Ste 305
Riverside, CA 92503-3957

Phone

(951) 343-3477

Fax

(951) 343-3486

NPI assigned

Oct 5, 2006

Organization subpart

No

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

Authorized official

Name

Iheanacho Emeruwa, M.D.NPI 1609871227

Title

Medical Director

Phone

(951) 343-3477

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Aspen Medical Group, Inc.

  • Obstetrics & Gynecology Physician
  • Corona, CA
  • NPI 1225304942

  O20040426001849

  Same enrollment
• Aspen Medical Group, Inc.

  • Obstetrics & Gynecology Physician
  • Moreno Valley, CA
  • NPI 1578958047

  O20040426001849

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Aspen Medical Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Aspen Medical Group, Inc.

  • Obstetrics & Gynecology Physician
  • Moreno Valley, CA
  • NPI 1578958047
  NPD tax ID

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Iheanacho Emeruwa, M.D.

  • Obstetrics Physician
  • Riverside, CA
  • NPI 1609871227

  Internal Medicine

  NPD (past) Authorized official
• Lisa K Banh, PA

  • Obstetrics & Gynecology Physician
  • Riverside, CA
  • NPI 1922009067
  NPD (past)
• Nicole Izetta Bostic, MD

  • Pediatrics Physician
  • Riverside, CA
  • NPI 1417159161
  NPD (past)
• Kevin Siwei Chen

  • Physician Assistant
  • Corona, CA
  • NPI 1184269284
  NPD (past)
• Jennie Le, M.D.

  • Pediatrics Physician
  • Corona, CA
  • NPI 1780002311
  NPD (past)
• Huong Quynh Nguyen, M.D.

  • Internal Medicine Physician
  • Corona, CA
  • NPI 1992199343
  NPD (past)
• Aki Shishido, CNM

  • Advanced Practice Midwife
  • Corona, CA
  • NPI 1083057574
  NPD (past)
• Camille Marie Stone, CNM

  • Advanced Practice Midwife
  • Beaumont, CA
  • NPI 1104682418
  NPD (past)
• Thao Dinh Tomczyk, PA-C

  • Medical Physician Assistant
  • Corona, CA
  • NPI 1306245519
  NPD (past)
• Elizabeth Mary Uppuluri, WHNP-BC, CNM

  • Advanced Practice Midwife
  • Corona, CA
  • NPI 1760942452
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707264000000",
    "number": "1295821296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9041 MAGNOLIA AVE STE 305",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033957",
            "telephone_number": "951-343-3477",
            "fax_number": "951-343-3486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9041 MAGNOLIA AVE STE 305",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033957",
            "telephone_number": "951-343-3477",
            "fax_number": "951-343-3486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASPEN MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A",
        "authorized_official_last_name": "EMERUWA",
        "authorized_official_first_name": "IHEANACHO",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "951-343-3477",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0094761",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN #",
            "identifier": "ZZZ28499Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victory Asia
• Amir Asifuddin, M.D.
• Derek Asilo
• Misael Aspe, OTR
• Aspen Anesthesia Group Inc
• Uri S Assa-Krutilin, PHARM.D
• Hedy S. Assaad, MD
• Martina Assad, D.D.S
• Assistive Health Systems, Inc.
• Assistive Health Systems, Inc.

• Obstetrics & Gynecology Physician in Riverside, CA
• Providers in Riverside, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.