Individual provider Active NPI

Oluwaseyi Okusanya, PA-C

  • Physician Assistant
  • Sacramento, CA
National Provider Identifier
1306481221
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2570 48TH St
Sacramento, CA 95817-1541
Phone
(916) 734-2145
NPI assigned
Nov 14, 2019
Reactivated
Apr 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X CA Primary

Addresses

Primary practice location

2570 48TH St
Sacramento, CA 95817-1541

Mailing address

16782 Von Karman Ave Ste 11
Irvine, CA 92606-2417
Phone (949) 833-2237

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
I20260310001192 CA Practitioner - Physician Assistant 1658854567 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of California, Davis School of Medicine, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4055 Valley View LN
Suite 700
Dallas, TX 75244-4910

4321 Norwood Ave
Apt 175
Sacramento, CA 95838-2683

5000 Hopyard Rd
Suite 410
Pleasanton, CA 94588-3145

5727 Peacock St
Houston, TX 77033-2414

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
67442CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Team Physicians of California Medical Group Inc Physician Assistant CurrentSince Apr 1, 2026 Accepting new patients
Signify Health Medical Associates of California, PC CurrentSince Mar 1, 2026 Accepting new patients
San Francisco Physicians International Medical Group, Inc Physician Assistant CurrentSince Apr 1, 2026 Accepting new patients

Locations

818 W 7th St
Ste 930
Los Angeles, CA 90017
Phone (800) 525-9202

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1573689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762819200000",
    "number": "1306481221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16782 VON KARMAN AVE STE 11",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926062417",
            "telephone_number": "949-833-2237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2570 48TH ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171541",
            "telephone_number": "916-734-2145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKUSANYA",
        "first_name": "OLUWASEYI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-14",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "deactivation_date": "2025-03-14",
        "reactivation_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.