Individual provider Active NPI

Olga I Emig, FNP

  • Family Nurse Practitioner
  • Yucaipa, CA
National Provider Identifier
1659966257
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95017225 Issued in CA
Practice address
33917 Lake Breeze Dr
Yucaipa, CA 92399-6912
Phone
(909) 702-3957
NPI assigned
Mar 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95017225 CA Primary

Addresses

Primary practice location

33917 Lake Breeze Dr
Yucaipa, CA 92399-6912

Mailing address

33917 Lake Breeze Dr
Yucaipa, CA 92399-6912
Phone (909) 702-3957

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
I20221021001572 CA Practitioner - Nurse Practitioner 1850767484 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - CaliforniaGroup PAC ID 6103739131, shared by 2 NPIs, 1,278 clinicians
Southern California Permanente Medical GroupGroup PAC ID 6002729175, shared by 4 NPIs, 11,250 clinicians

Practice addresses (Care Compare)

1001 N Tustin Ave
Santa Ana, CA 92705-3502
Phone (714) 835-3555

2295 S Vineyard Ave
Ontario, CA 91761-7925
Phone (909) 724-5000

9961 Sierra Ave
Fontana, CA 92335-6720
Phone (909) 427-5000

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95017225CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Jul 9, 2022 Accepting new patients
Cep America-California CurrentSince Nov 8, 2023 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jul 9, 2022 Accepting new patients
Cep America - California CurrentSince Nov 8, 2023 Accepting new patients
Cep America - California CurrentSince Nov 8, 2023 Accepting new patients
Southern California Permanente Medical Group CurrentSince Apr 16, 2024 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Cep America - California Current Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784

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

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

350 Terracina Blvd
Redlands, CA 92373
Phone (909) 335-5500

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

1001 N Tustin Ave
Santa Ana, CA 92705
Phone (714) 835-3555

Interoperability endpoints

  • Direct secure messaging: olga.emig@247445671575556.direct.elationemr.com

Organizations & group practices 10

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": "1614816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1659966257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33917 LAKE BREEZE DR",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923996912",
            "telephone_number": "909-702-3957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33917 LAKE BREEZE DR",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923996912",
            "telephone_number": "909-702-3957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMIG",
        "first_name": "OLGA",
        "middle_name": "I",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-04",
        "last_updated": "2022-11-21",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95017225",
            "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": "4733 W Sunset Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900276021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Yucaipa, CA

Sources for this page

Verify at the official NPI Registry.