Sandra Imade Odiase, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

17711 Issued in CA

Practice address

3946 Norwood Ave
Sacramento, CA 95838-3300

Phone

(916) 564-0521

Fax

(877) 860-2907

NPI assigned

Apr 7, 2008

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

Other identifiers 3

Other names 1

• Sandra Imade Odiase Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19797/brand/1/csg/1/fhir/r4

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.

• Capital Medical Extended Care

  • Skilled Nursing Facility
  • Sacramento, CA
  • NPI 1295131092
  NPD (past)
• Molina Healthcare of California

  dba Molina Medical Centers

  • Health Maintenance Organization
  • Long Beach, CA
  • NPI 1194811760
  NPD (past)
• Molina Healthcare of California

  • Family Medicine Physician
  • Sacramento, CA
  • NPI 1841305075
  NPD (past)

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

{
    "created_epoch": "1207526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439164800000",
    "number": "1366615791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 OCEANGATE",
            "address_2": "SUITE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024317",
            "telephone_number": "562-499-6191",
            "fax_number": "877-860-5422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3946 NORWOOD AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958383300",
            "telephone_number": "916-564-0521",
            "fax_number": "877-860-2907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODIASE",
        "first_name": "SANDRA",
        "middle_name": "IMADE",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-07",
        "last_updated": "2015-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "17711",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "17711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EFF: 11/13/2014",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01470028-DV5277",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01421065 - DS9933",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "ODIASE",
            "middle_name": "IMADE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Dena Odeh
• Tamiko Odem
• Ashlyn Oden
• Myah Nyree Oden
• Ayooluwa Abibat Odeyemi, LCSW
• Charles Odipo, ED. D
• Thadeus John Odom, MD
• Tira Odom
• Medua Odum
• Rachelle Oehlert

• Nurse Practitioner in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.