Individual provider Active NPI

Monique Ofwono, PA

  • Physician Assistant
  • Escondido, CA
National Provider Identifier
1417987223
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA55290 Issued in CA
Practice address
2185 Citracado Pkwy
Escondido, CA 92029-4159
Phone
(442) 281-5000
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X PA030309 DC
Physician Assistant 363A00000X PA55290 CA Primary

Addresses

Primary practice location

2185 Citracado Pkwy
Escondido, CA 92029-4159

Mailing address

2100 Powell St
Ste 900
Emeryville, CA 94608-1826
Phone (510) 350-2600

Other practice location 1

1150 Varnum St NE
Washington, DC 20017-2104
Phone (202) 269-7001

Electronic endpoints 1

TypeEndpointUseAffiliation
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180126001237 CA Practitioner - Physician Assistant 4183612286 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA55290CAMDPhysician Assistant
PA030309DCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Urgent Care Inc. CurrentSince Dec 15, 2021 Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 19, 2022 Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 19, 2022 Accepting new patients
Cep America - California CurrentSince Jan 19, 2018 Accepting new patients
Dimensions Health Corporation Past Accepting new patients
Anacostia River Emergency Physicians LLC Past Accepting new patients
Contee Emergency Physicians Physician Assistant Past Accepting new patients

Locations

9710 Brimhall Rd
Bakersfield, CA 93312
Phone (661) 331-8640

212 Coffee Rd
Ste 100
Bakersfield, CA 93309
Phone (661) 885-6060

4108 Edison Ave
Ste 112
Chino, CA 91710
Phone (909) 334-4545

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

6789 N Blackstone Ave
Fresno, CA 93710
Phone (559) 512-3377

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1600 N Rose Ave
Oxnard, CA 93030
Phone (805) 988-2500

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

41540 Winchester Rd
Temecula, CA 92590
Phone (951) 365-5585

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1417987223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST",
            "address_2": "STE 900",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "510-350-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2185 CITRACADO PKWY",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920294159",
            "telephone_number": "442-281-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1150 Varnum St NE",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200172104",
            "country_code": "US",
            "telephone_number": "202-269-7001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OFWONO",
        "first_name": "MONIQUE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DC",
            "license": "PA030309",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA55290",
            "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": "10800 Magnolia Ave",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925053043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

Verify at the official NPI Registry.