Priscilla Naamomo Otubuah, PHD, DNP, FNP, B-C;

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95000921 Issued in CA

Practice address

24950 Redlands Blvd Ste F
Loma Linda, CA 92354-4028

Phone

(909) 440-6849

Fax

(909) 440-6840

NPI assigned

Sep 19, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Doctor of Philosophy

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15368/brand/1/csg/1/fhir/r4
• Direct secure messaging: priscilla.otubuah.1@19408.direct.athenahealth.com

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.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846
  Medicare reassignment NPD
• Nightingale Clinical Care, PC

  • Primary Care Clinic/Center
  • Riverside, CA
  • NPI 1972159069
  Medicare reassignment NPD
• Ultimate Medical Practice a Professional Corporation

  • Primary Care Clinic/Center
  • Highland, CA
  • NPI 1962659573
  Medicare reassignment NPD
• Omanye Behavioral Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Loma Linda, CA
  • NPI 1770175291
  NPD Authorized official
• Redlands Community Hospital

  • General Acute Care Hospital
  • Redlands, CA
  • NPI 1043354111
  NPD (past)

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

{
    "created_epoch": "1411084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1437551561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24950 REDLANDS BLVD STE F",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923544028",
            "telephone_number": "909-283-4033",
            "fax_number": "855-621-1987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24950 REDLANDS BLVD STE F",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923544028",
            "telephone_number": "909-440-6849",
            "fax_number": "909-440-6840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTUBUAH",
        "first_name": "PRISCILLA",
        "middle_name": "NAAMOMO",
        "name_prefix": "Dr.",
        "credential": "PHD, DNP, FNP, B-C;",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-19",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95000921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Ariana Ostad
• Erika K Osterholzer, MD
• Christa Marie Osuna, LCSW
• Kimberly Nalani Otsuka, M.D.
• Takahiro Otsuka, MD
• Genevieve Chioma Otuonye, REGISTERED NURSE
• Harry William Ou, M.D.
• Aislyn Oulee, MD
• Evelyn A Ouro-Rodrigues
• Isaac David Overfield

• Family Nurse Practitioner in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2023; 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.