Kenneth Ejiogu

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95011746 Issued in CA

Practice address

1127 Wilshire Blvd Ste 800
Los Angeles, CA 90017-3909

Phone

(213) 839-1119

NPI assigned

Nov 5, 2018

Last updated

Apr 8, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Healthcare Partners Affiliates Medical GroupGroup PAC ID 7315842002, 775 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

21.02 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

70.08

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kejiogu206688@westdirect.optum.com

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.

• Healthcare Partners Affiliates Medical Group

  dba Optum

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1659312593
  Medicare reassignment Care Compare group NPD
• Algos Inc., a Medical Corporation

  dba Synovation Medical Group

  • Pain Medicine Physician
  • Pasadena, CA
  • NPI 1497747356
  Medicare reassignment NPD
• Pain Clinics of Central California, Inc.

  • Pain Medicine Physician
  • Visalia, CA
  • NPI 1861060733
  Medicare reassignment NPD
• Algos Inc., a Medical Corporation

  dba Synovation Medical Group

  • Pain Medicine Physician
  • Simi Valley, CA
  • NPI 1063890275
  NPD
• Algos Inc., a Medical Corporation

  dba Synovation Medical Group

  • Pain Medicine Physician
  • Visalia, CA
  • NPI 1245832419
  NPD
• Algos Inc., a Medical Corporation

  dba Synovation Medical Group

  • Physical Therapist
  • Azusa, CA
  • NPI 1639629595
  NPD
• Healthcare Partners Affiliates Medical Group

  dba Optum

  • Durable Medical Equipment & Medical Supplies
  • Murrieta, CA
  • NPI 1760057269
  NPD
• Lags Spine and Sportscare Medical Centers Inc

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Santa Maria, CA
  • NPI 1447244256
  NPD (past)
• Lags Spine and Sportscare Medical Centers, Inc.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Hayward, CA
  • NPI 1962983965
  NPD (past)
• Regenerative Spine, Pain, and Neuropathy Centers, Inc.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Bakersfield, CA
  • NPI 1497323570
  NPD (past)

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

{
    "created_epoch": "1541376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1639647019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10565 CIVIC CENTER DR",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 WILSHIRE BLVD STE 800",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900173909",
            "telephone_number": "213-839-1119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10565 Civic Center Dr",
            "address_purpose": "LOCATION",
            "city": "Rancho Cucamonga",
            "state": "CA",
            "postal_code": "917303853",
            "country_code": "US",
            "telephone_number": "469-237-7389",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EJIOGU",
        "first_name": "KENNETH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-05",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95011746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Joseph Eisner, MD
• Robert W Eitches
• Ejc Transport LLC
• Elaine Mekdela Ejigu
• Walter Iweka Ejinaka
• Amir T. Ekanej, MD
• Ekaterina N. Galina, DDS,Professional Dental Corporation
• Raphael E Ekeagwu
• Michael Ekeinde
• Nnenna Irochi Ekejiuba, PSYCH NP

• Family Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, 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 Apr 8, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.