Individual provider Active NPI

Osamamwode Sunday Ogbeiwi, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Brea, CA
National Provider Identifier
1609047166
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
17752 Issued in CA
Practice address
101 W Central Ave
Suite B120
Brea, CA 92821-7515
Phone
(714) 709-3154
NPI assigned
Mar 12, 2008
Last updated
Nov 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 17752 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 17752 CA Primary

Addresses

Primary practice location

101 W Central Ave
Suite B120
Brea, CA 92821-7515

Mailing address

954 Barbara LN
Pomona, CA 91767-4118
Phone (714) 709-3154

Other identifiers 2

IdentifierTypeStateIssuer
2007010341OtherCAFNP - ANCC
17752OtherCAFNP-BC

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
I20120614000107 CA Practitioner - Nurse Practitioner 5496919920 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oceanside Medical Group a Medical CorporationGroup PAC ID 9335311042, 18 clinicians

Practice addresses (Care Compare)

701 Santa Monica Blvd
Suite 230
Santa Monica, CA 90401-2625
Phone (310) 993-4103

933 S Sunset Ave
Suite 105
West Covina, CA 91790-3410
Phone (626) 813-1222

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17752CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Aimant Hospice, Inc. Current Accepting new patients
Moiez Khankhanian, M.D. Inc CurrentSince Dec 24, 2019 Accepting new patients
Anita Home Health, Inc. CurrentSince Nov 18, 2018 Accepting new patients
Globe Nursing NP Prof Corp Family CurrentSince Oct 1, 2013 Accepting new patients
Oceanside Medical Group, a Medical Corporation CurrentSince Apr 29, 2012 Accepting new patients

Locations

1025 S Anaheim Blvd
Anaheim, CA 92805
Phone (714) 533-6220

320 Cattle Call Dr
Brawley, CA 92227
Phone (760) 344-5431

1100 W Morton Ave
Porterville, CA 93257
Phone (559) 782-1509

7500 Hellman Ave
Rosemead, CA 91770
Phone (616) 288-1160

701 Santa Monica Blvd
Ste 230
Santa Monica, CA 90401
Phone (310) 993-4103

44280 Campanula Way
Temecula, CA 92592
Phone (951) 302-1122

867 E 11th St
Upland, CA 91786
Phone (909) 227-0750

640 S Sunset Ave
Ste 102
West Covina, CA 91790
Phone (626) 338-9000

933 S Sunset Ave
Ste 105
West Covina, CA 91790
Phone (626) 813-1222

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Anita Home Health IncEl Monte, CA, CCN 757028 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Corporate Officer (100%)
Corporate Director (100%)
W-2 Managing Employee (100%)
Nov 18, 2018
Nov 18, 2018
Nov 18, 2018
Nov 18, 2018

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1205280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1609047166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "954 BARBARA LN",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917674118",
            "telephone_number": "714-709-3154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W CENTRAL AVE",
            "address_2": "SUITE B120",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928217515",
            "telephone_number": "714-709-3154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGBEIWI",
        "first_name": "OSAMAMWODE",
        "middle_name": "SUNDAY",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-12",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "17752",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "17752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FNP - ANCC",
            "identifier": "2007010341",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FNP-BC",
            "identifier": "17752",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brea, CA

Sources for this page

Verify at the official NPI Registry.