Individual provider Active NPI

Maureen Nmachukwu Eghreriniovo, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Murrieta, CA
National Provider Identifier
1770765547
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95020157 Issued in CA
Practice address
24910 Las Brisas Rd
Murrieta, CA 92562-4010
Phone
(888) 873-6220
NPI assigned
Dec 3, 2007
Last updated
Mar 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95020157 CA Primary
Counselor 101Y00000X NU
Registered Nurse 163W00000X 814988 CA

Addresses

Primary practice location

24910 Las Brisas Rd
Murrieta, CA 92562-4010

Mailing address

24910 Las Brisas Rd Ste 121
Murrieta, CA 92562-4035
Phone (888) 873-6200

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
I20240531003937 CA Practitioner - Nurse Practitioner 1759823040 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. John's Community HealthGroup PAC ID 2961482690, 151 clinicians

Practice addresses (Care Compare)

808 W 58TH St
Los Angeles, CA 90037-3632
Phone (323) 541-1400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
814988CAMDRegistered Nurse
95020157CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Johns Community Health CurrentSince Jun 1, 2024 Accepting new patients
St. Johns Community Health Current Accepting new patients
St. Johns Community Health CurrentSince Jun 1, 2024 Accepting new patients
Kolli Medical Corporation CurrentSince May 8, 2024 Accepting new patients
St. Johns Community Health Past Accepting new patients
Vine Care Center Inc Past Accepting new patients

Locations

2115 N Wilmington Ave
Compton, CA 90222
Phone (310) 603-1332

1600 E Florida Ave
Ste 103
Hemet, CA 92544
Phone (951) 925-6625

1821 S San Jacinto Ave
Ste D
San Jacinto, CA 92583
Phone 32328598302332

1500 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 381-1591

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1770765547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24910 LAS BRISAS RD STE 121",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925624035",
            "telephone_number": "888-873-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24910 LAS BRISAS RD",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925624010",
            "telephone_number": "888-873-6220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGHRERINIOVO",
        "first_name": "MAUREEN",
        "middle_name": "NMACHUKWU",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-03",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95020157",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "814988",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

Verify at the official NPI Registry.