Active NPI
Marcellina Nwosu, MD
- Adult Health Nurse Practitioner
- Palm Springs, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- CNP-55239
- Practice address
- 555 E Tachevah Dr Ste 2E204
Palm Springs, CA 92262-5737 - Phone
- (575) 395-7246
- NPI assigned
- Dec 10, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 0024191273 | VA | |
| Adult Health Nurse Practitioner | 363LA2200X | 311496 | NY | |
| Adult Health Nurse Practitioner | 363LA2200X | CNP-55239 | NM | Primary |
Addresses
Primary practice location
555 E Tachevah Dr Ste 2E204
Palm Springs, CA 92262-5737
Mailing address
555 E Tachevah Dr Ste 2E204
Palm Springs, CA 92262-5737
Phone (760) 561-7344
Other practice location 1
156 William St Rm 303
New York, NY 10038-5307
Phone (888) 803-3370
Other practice location 2
215 Cowboy Way
Edgewood, NM 87015-9616
Phone (888) 803-3370
Other practice location 3
2800 Eisenhower Ave Ste 220
Alexandria, VA 22314-4587
Phone (888) 803-3370
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 28586271 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
331 1St St a
San Francisco, CA 94105-2661
PO Box
Dallas, TX 75373
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 311496 | NY | MD | Pediatrics Physician |
| CNP-55239 | NM | MD | Adult Health Nurse Practitioner |
| 0024191273 | VA | MD | Adult Health Nurse Practitioner |
Interoperability endpoints
- marcellina.nwosu.1@14035.direct.athenahealth.com
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.
-
- Family Medicine Physician
- New York, NY
- NPI 1780425447
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1418169600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774915200000",
"number": "1891193694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 E TACHEVAH DR STE 2E204",
"city": "PALM SPRINGS",
"state": "CA",
"postal_code": "922625737",
"telephone_number": "760-561-7344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 E TACHEVAH DR STE 2E204",
"city": "PALM SPRINGS",
"state": "CA",
"postal_code": "922625737",
"telephone_number": "575-395-7246"
}
],
"practiceLocations": [
{
"address_1": "156 William St Rm 303",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100385307",
"country_code": "US",
"telephone_number": "888-803-3370",
"fax_number": "888-803-3331",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "215 Cowboy Way",
"address_purpose": "LOCATION",
"city": "Edgewood",
"state": "NM",
"postal_code": "870159616",
"country_code": "US",
"telephone_number": "888-803-3370",
"fax_number": "888-803-3331",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2800 Eisenhower Ave Ste 220",
"address_purpose": "LOCATION",
"city": "Alexandria",
"state": "VA",
"postal_code": "223144587",
"country_code": "US",
"telephone_number": "888-803-3370",
"fax_number": "888-803-3331",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NWOSU",
"first_name": "MARCELLINA",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-12-10",
"last_updated": "2026-03-31",
"certification_date": "2026-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "VA",
"license": "0024191273",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NY",
"license": "311496",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NM",
"license": "CNP-55239",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "28586271",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Palm Springs, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2026; 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.