Ida Selena Obeso-Martinez, FNP
Individual provider Active NPI Family Nurse Practitioner · El Centro, CA
NPI 1831629252 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1831629252
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- NP95006588 (CA)
- Practice address
- 2061 Ross Ave Ste B
El Centro, CA 92243-3687 - Phone
- (760) 352-5800
- NPI assigned
- Jun 18, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Imperial Valley Family Care Medical Group a P C
Practice addresses (Care Compare)
516 W Aten Rd
Suite 1
Imperial, CA 92251-9805
Phone (760) 355-8300
Hospital & facility affiliations
- El Centro Regional Medical Center
- Pioneers Memorial Healthcare District
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170906003969 | CA | Practitioner - Nurse Practitioner | 3072886464 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95006588 | CA | MD | Family Nurse Practitioner |
| NP95006588 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Imperial Valley Family Care Medical Group, Apc | Current |
Accepting new patients | |
| Ceja & Singh a Medical Corporation | Family | Current |
Accepting new patients |
| Imperial Valley Family Care Medical Group Apc | Current |
Accepting new patients | |
| El Centro Regional Medical Center | Past | Accepting new patients |
Locations
207 W Legion Rd
Brawley, CA 92227
Phone (760) 351-3333
125 S 5th St
Brawley, CA 92227
Phone (760) 344-8100
251 W Cole Blvd
Calexico, CA 92231
Phone (760) 357-3768
1550 N Imperial Ave
Ste 1
El Centro, CA 92243
Phone (760) 352-1731
2061 Ross Ave
Ste B
El Centro, CA 92243
Phone (760) 352-5800
516 W Aten Rd
Ste 2
Imperial, CA 92251
Phone (760) 355-7730
516 W Aten Rd
Ste 1
Imperial, CA 92251
Phone (760) 355-7748
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | NP95006588 | CA | |
| Family Nurse Practitioner | 363LF0000X | 95006588 | CA | |
| Family Nurse Practitioner | 363LF0000X | NP95006588 | CA | Yes |
Addresses
Primary practice location
2061 Ross Ave Ste B
El Centro, CA 92243-3687
Mailing address
2061 Ross Ave
El Centro, CA 92243-3687
Phone (760) 352-5800
Other practice location 1
2026 N Imperial Ave Ste C
El Centro, CA 92243-1607
Phone (760) 592-4595
Other practice location 2
4231 US Highway 86 Ste 6
Brawley, CA 92227-9648
Phone (760) 790-0005
Other providers in El Centro, CA
- Joshua Elijah Nunez
- Natalia Paola Nunez
- Sandra CH Nunez
- Diana Nuno
- Dunia Nuno
- Oc Hospitalist Group, Inc
- Luz G. Ocegueda
- Zulema Ocegueda
- Ariadna Julissa Oceguera
- Alejandra Ochoa
All providers in El Centro, CA · Family Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.