Individual provider Active NPI

Feyi Nneka Emembolu, M.D.

  • Emergency Medicine Physician
  • Palmdale, CA
National Provider Identifier
1366690018
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
125.052904 Issued in IL
Practice address
38600 Medical Center Dr
Palmdale, CA 93551-4483
Phone
(661) 382-6000
NPI assigned
Sep 7, 2008
Last updated
Sep 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A111176 CA
Emergency Medicine Physician 207P00000X 125.052904 IL Primary

Addresses

Primary practice location

38600 Medical Center Dr
Palmdale, CA 93551-4483

Mailing address

PO Box 40050
Studio City, CA 91614-4050

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100810000741 CA Practitioner - Emergency Medicine 4284775586 Reassigns benefits to 6 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125.052904ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Presbyterian Emergency Medical Associates Emergency Medicine CurrentSince Mar 1, 2014 Accepting new patients
Sherman Oaks Emergency Medical Associates Emergency Medicine CurrentSince Jul 20, 2013 Accepting new patients
Glendale Emergency Medical Associates, Inc Emergency Medicine CurrentSince Apr 10, 2019 Accepting new patients

Locations

1420 S Central Ave
Glendale, CA 91204
Phone (818) 502-1900

15107 Vanowen St
Van Nuys, CA 91405
Phone (818) 782-6600

4929 Van Nuys Blvd
Van Nuys, CA 91403
Phone (818) 907-4561

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1220745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1366690018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40050",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916144050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38600 MEDICAL CENTER DR",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935514483",
            "telephone_number": "661-382-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMEMBOLU",
        "first_name": "FEYI",
        "middle_name": "NNEKA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-07",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A111176",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125.052904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

Verify at the official NPI Registry.