Active NPI
Caroline O Egekeze, M.D.
- Pediatrics Physician
- Lynwood, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A86266
- Practice address
- 3737 Martin Luther King Jr Blvd
Suite 204
Lynwood, CA 90262-3513 - Phone
- (310) 537-1221
- Fax
- (310) 764-2409
- NPI assigned
- Jul 17, 2006
- Last updated
- Dec 6, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A86266 | CA | Primary |
Addresses
Primary practice location
3737 Martin Luther King Jr Blvd
Suite 204
Lynwood, CA 90262-3513
Mailing address
3737 Martin Luther King Jr Blvd
Suite 204
Lynwood, CA 90262-3513
Phone (310) 537-1221
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| T H E Clinic Inc | Current | Accepting new patients | |
| Mission City Community Network, Inc. | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Mission City Community Network, Inc. | Current | Accepting new patients | |
| Mission City Community Network, Inc. | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| James E. Saunders, M.D., Inc. | Past | Accepting new patients |
Locations
5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088
3834 S Western Ave
Los Angeles, CA 90062
Phone (323) 730-1920
4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784
8363 Reseda Blvd
Ste 11
Northridge, CA 91324
Phone 8188953100602
393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914
15206 Parthenia St
Sepulveda, CA 91343
3900 Alamo St
Simi Valley, CA 93063
Phone (805) 582-0100
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- caroline.egekeze@theci.eclinicaldirectplus.com
Organizations & group practices 8
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Hollywood, CA
- NPI 1710102009
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- Clinic/Center
- Los Angeles, CA
- NPI 1023287679
-
- Primary Care Clinic/Center
- Monrovia, CA
- NPI 1063795250
-
- Community Health Clinic/Center
- North Hills, CA
- NPI 1710370747
-
- Health Maintenance Organization
- Los Angeles, CA
- NPI 1134151657
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
-
- Pediatric Adolescent Medicine Physician
- Lynwood, CA
- NPI 1326414491
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638748800000",
"number": "1407873102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3737 MARTIN LUTHER KING JR BLVD",
"address_2": "SUITE 204",
"city": "LYNWOOD",
"state": "CA",
"postal_code": "902623513",
"telephone_number": "310-537-1221",
"fax_number": "310-764-2409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3737 MARTIN LUTHER KING JR BLVD",
"address_2": "SUITE 204",
"city": "LYNWOOD",
"state": "CA",
"postal_code": "902623513",
"telephone_number": "310-537-1221",
"fax_number": "310-764-2409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EGEKEZE",
"first_name": "CAROLINE",
"middle_name": "O",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-17",
"last_updated": "2021-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A86266",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "4733 W Sunset Blvd",
"city": "Los Angeles",
"state": "CA",
"country_code": "US",
"postal_code": "900276021",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Lynwood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.