Ogbanedi John Abu, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA22087 Issued in CA

Practice address

415 W Benjamin Holt Dr
Stockton, CA 95207-3958

Phone

(209) 477-4103

Fax

(209) 477-1065

NPI assigned

Feb 28, 2012

Last updated

Feb 28, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Merit-based Incentive Payment System (MIPS)

Final score

96.69 of 100Reported as group

Quality

90

Improvement activities

40

Cost

78.43

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19797/brand/1/csg/1/fhir/r4

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.

• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1023063542
  Medicare reassignment
• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • Santa Ana, CA
  • NPI 1548667843
  Medicare reassignment
• Chandan DS Cheema MD Inc

  dba Capital Medical Extended Care

  • Internal Medicine Physician
  • Fair Oaks, CA
  • NPI 1598965667
  Medicare reassignment
• Community Health Centers of America

  • Federally Qualified Health Center (FQHC)
  • Mariposa, CA
  • NPI 1891207684
  Medicare reassignment
• Cep America-California

  • Emergency Medicine Physician
  • Los Alamitos, CA
  • NPI 1497430870
  NPD
• Cep America-California

  • Emergency Medicine Physician
  • Murrieta, CA
  • NPI 1588552848
  NPD
• Cep America-California

  • Emergency Medicine Physician
  • Jackson, CA
  • NPI 1871303974
  NPD
• Community Health Centers of America

  • Federally Qualified Health Center (FQHC)
  • Gustine, CA
  • NPI 1245105733
  NPD
• Capital Medical Extended Care

  • Skilled Nursing Facility
  • Sacramento, CA
  • NPI 1295131092
  NPD (past)

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

{
    "created_epoch": "1330387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330387200000",
    "number": "1750655353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 580244",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957580005",
            "telephone_number": "209-472-6624",
            "fax_number": "209-477-1065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 W BENJAMIN HOLT DR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952073958",
            "telephone_number": "209-477-4103",
            "fax_number": "209-477-1065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABU",
        "first_name": "OGBANEDI",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-28",
        "last_updated": "2012-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA22087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Magdalena Guadalupe Abrica
• William Abriel
• Salvador Antonio Absalon Ramos
• Bader Abu Ghalyoun, MD
• Moroug Abu-Arqoub
• Jesse Rios Abundez
• Abdul Abuzaina
• Access Mobility Transport
• Access Physician Inc.
• Acclimation, Inc.

• Physician Assistant in Stockton, CA
• Providers in Stockton, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2012; 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.