Magnus Okechukwu Duru, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95018651 Issued in CA

Practice address

121 Paul Dr Ste a
San Rafael, CA 94903-2047

Phone

(415) 578-4983

Fax

(415) 578-7435

NPI assigned

Oct 7, 2021

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

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bay Area Mobile Medical Group IncGroup PAC ID 7911384144, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Bay Area Mobile Medical Group, Inc.

  • General Practice Physician
  • San Rafael, CA
  • NPI 1265187272
  Medicare reassignment Care Compare group
• Hysab Incorporated

  • Family Nurse Practitioner
  • Ceres, CA
  • NPI 1487452892
  NPD (past)

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

{
    "created_epoch": "1633564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1891457792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 PAUL DR STE A",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032047",
            "telephone_number": "510-631-7451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 PAUL DR STE A",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032047",
            "telephone_number": "415-578-4983",
            "fax_number": "415-578-7435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4640 Admiralty Way Ste 500",
            "address_purpose": "LOCATION",
            "city": "Marina Del Rey",
            "state": "CA",
            "postal_code": "902926636",
            "country_code": "US",
            "telephone_number": "510-328-7435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DURU",
        "first_name": "MAGNUS",
        "middle_name": "OKECHUKWU",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-07",
        "last_updated": "2023-12-12",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95018651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE",
            "identifier": "95018651",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jill K. Dunton, MD
• Andrew Tien Duong, MD
• Amelia Duplantier, RD
• Durango Investments Inc.
• Torsten Hall Durkan
• Kyle Ryan Duva, PSY.D.
• Cameron Duvall
• Cynthia Jaramillo Duxbury, MFT
• Susan Ann Dyer, PSY.D.
• Kathleen Ann Eagle, PSYD

• Nurse Practitioner in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; 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.