Individual provider Active NPI

Emmanuel Ndubuisi Njoku, FNP-C

  • Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1467021535
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95028343 Issued in CA
Practice address
200 N Main St
Los Angeles, CA 90012-4110
Phone
(213) 473-9311
NPI assigned
Jun 22, 2021
Last updated
Dec 13, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95028343 CA Primary
Registered Nurse 163W00000X 95246329 CA

Addresses

Primary practice location

200 N Main St
Los Angeles, CA 90012-4110

Mailing address

520 E Temple St
Los Angeles, CA 90012-4024
Phone (213) 473-9311

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
I20240315000519 CA Practitioner - Nurse Practitioner 8325484124 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12157 Victory Blvd
N Hollywood, CA 91606-3204
Phone (818) 755-8000

8316 Foothill Blvd
Sunland, CA 91040-2850
Phone (818) 273-8800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Community Health Centers, Inc Single Specialty CurrentSince Mar 11, 2024 Accepting new patients
Comprehensive Community Health Centers Inc Single Specialty Current Accepting new patients
Special Service for Groups, Inc. PastSince Jun 1, 2021 Accepting new patients

Locations

801 S Chevy Chase Dr
Ste 20
Glendale, CA 91205
Phone (818) 265-2210

801 S Chevy Chase Dr
Ste 250
Glendale, CA 91205
Phone (818) 265-2259

1704 Colorado Blvd
Los Angeles, CA 90041
Phone (323) 256-4116

8316 Foothill Blvd
Sunland, CA 91040
Phone (818) 273-8800

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1467021535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 E TEMPLE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900124024",
            "telephone_number": "213-473-9311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N MAIN ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900124110",
            "telephone_number": "213-473-9311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NJOKU",
        "first_name": "EMMANUEL",
        "middle_name": "NDUBUISI",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-22",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95028343",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95246329",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.