Individual provider Active NPI

Shoko Okado Nitta, NP

  • Acute Care Nurse Practitioner
  • Riverside, CA
National Provider Identifier
1780917021
Registry record updated Jan 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
18472 Issued in CA
Practice address
4500 Brockton Ave Ste 319
Riverside, CA 92501-4027
Phone
(951) 367-0102
NPI assigned
Sep 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Clinical Nurse Specialist 364SA2100X 3037 CA
Acute Care Nurse Practitioner 363LA2100X 18472 CA Primary

Addresses

Primary practice location

4500 Brockton Ave Ste 319
Riverside, CA 92501-4027

Mailing address

4500 Brockton Ave Ste 319
Riverside, CA 92501-4027
Phone (951) 384-7422

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
I20190125003024 CA Practitioner - Nurse Practitioner 5799022927 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3037CAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
California Neurointerventional Surgeons, Inc CurrentSince Jul 1, 2020 Accepting new patients

Locations

26520 Cactus Ave
Moreno Valley, CA 92555
Phone (951) 486-5610

700 E Redlands Blvd
Ste 714
Redlands, CA 92373

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

Organizations & group practices 1

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": "1253145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548633600000",
    "number": "1780917021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 BROCKTON AVE STE 319",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014027",
            "telephone_number": "951-384-7422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 BROCKTON AVE STE 319",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014027",
            "telephone_number": "951-367-0102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NITTA",
        "first_name": "SHOKO",
        "middle_name": "OKADO",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-17",
        "last_updated": "2019-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "CA",
            "license": "3037",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "18472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.