Jane Ekejiuba, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A123455 Issued in CA

Practice address

21501 Avalon Blvd
Suite 100
Carson, CA 90745-2201

Phone

(310) 835-6627

NPI assigned

Apr 27, 2010

Last updated

Mar 31, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Medical InstituteGroup PAC ID 5991609737, 303 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Little Company of Mary Med Ctr Torrance Hospital, Torrance, CA, CCN 050353
• Torrance Memorial Medical Center Hospital, Torrance, CA, CCN 050351

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Providence Medical Institute

  dba Providence Little Company of Mary Medical Institute

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1417915760
  Medicare reassignment Care Compare group NPD
• Providence Medical Institute

  dba Providence Little Company of Mary Medical Institute

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1235182569
  NPD
• Providence Medical Institute

  dba Providence Little Company of Mary

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1356394175
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health System Southern California

  dba Providence Little Company of Mary Medical Center Torrance

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1902844988
  Care Compare affiliation
• Torrance Memorial Medical Center

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1467459776
  Care Compare affiliation

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

{
    "created_epoch": "1272326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1346567617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21501 AVALON BLVD",
            "address_2": "SUITE 100",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907452201",
            "telephone_number": "310-835-6627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21501 AVALON BLVD",
            "address_2": "SUITE 100",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907452201",
            "telephone_number": "310-835-6627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKEJIUBA",
        "first_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-27",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A123455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jekejiuba305655@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "21501 Avalon Blvd",
            "address_2": "SUITE 100",
            "city": "Carson",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907452201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jekejiuba305655@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "20401 Avalon Blvd Ste B",
            "city": "Carson",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907463226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Family Medicine Physician in Carson, CA
• Providers in Carson, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.