Emmanuel Nosa Obanor, DO

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

20A6988 Issued in CA

Practice address

999 S Fairmont Ave
Suite 125
Lodi, CA 95240-5100

Phone

(209) 334-8514

Fax

(209) 366-2661

NPI assigned

Jun 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Gastroenterology

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pulmonary Medicine Associates Medical Group Inc.Group PAC ID 4981506730, 93 clinicians

County of San JoaquinGroup PAC ID 6002703436, 199 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Joaquin General Hospital Hospital, French Camp, CA, CCN 050167
• St Joseph'S Medical Center of Stockton Hospital, Stockton, CA, CCN 050084
• Vibra Hospital of Sacramento Long-term care hospital, Folsom, CA, CCN 052033

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• County of San Joaquin

  • General Acute Care Hospital
  • French Camp, CA
  • NPI 1801830583
  Medicare reassignment Care Compare group NPD
• Pulmonary Medicine Associates Medical Group, Inc

  • Pulmonary Disease Physician
  • Sacramento, CA
  • NPI 1407880719
  Medicare reassignment Care Compare group NPD
• Amplehealth

  • Internal Medicine Physician
  • Carmichael, CA
  • NPI 1508899758
  Medicare reassignment NPD
• San Joaquin Faculty Medical Group

  • Internal Medicine Physician
  • French Camp, CA
  • NPI 1225063761
  Medicare reassignment NPD
• Vibra Physicians LLC

  • Hospitalist Physician
  • Johnstown, CO
  • NPI 1659705424

  CA

  Medicare reassignment NPD
• 1125 Sir Francis Drake Boulevard Operating Company, LLC

  • Long Term Care Hospital
  • Kentfield, CA
  • NPI 1760424261
  NPD
• County of San Joaquin

  • Multi-Specialty Clinic/Center
  • Manteca, CA
  • NPI 1417407636
  NPD
• Pulmonary Medicine Associates Sleep Lab Inc.

  • Sleep Disorder Diagnostic Clinic/Center
  • Sacramento, CA
  • NPI 1255359378
  NPD

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

• County of San Joaquin

  • General Acute Care Hospital
  • French Camp, CA
  • NPI 1992870430
  Care Compare affiliation
• Port City Operating Company, LLC

  • General Acute Care Hospital
  • Stockton, CA
  • NPI 1528190931
  Care Compare affiliation
• Vibra Hospital of Sacramento LLC

  • Long Term Care Hospital
  • Folsom, CA
  • NPI 1134564693

  Long-term care hospital

  Care Compare affiliation

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1689615007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 241011",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952419511",
            "telephone_number": "209-339-7435",
            "fax_number": "209-333-3054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 S FAIRMONT AVE",
            "address_2": "SUITE 125",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952405100",
            "telephone_number": "209-334-8514",
            "fax_number": "209-366-2661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBANOR",
        "first_name": "EMMANUEL",
        "middle_name": "NOSA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A6988",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "20A6988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Regina Ann Nordman, MFT
• Rosemary Nunez-Davis, D.O.
• Phoebe Nunez
• Theodore Nwoke
• Michael Robert O'Connell, DC
• Alma Ochoa, PHARMD
• Yvonne Ochoa
• Tomio T. Odama, M.D.
• Priscilla Alexandra Ohnmacht
• Janel Ojeda, PA-C

• Gastroenterology Physician in Lodi, CA
• Providers in Lodi, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2017; 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.