Individual provider Active NPI

Anandi S Ohkubo

  • Nurse Practitioner
  • Santa Rosa, CA
National Provider Identifier
1912793977
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95039154 Issued in CA
Practice address
208 Concourse Blvd
Santa Rosa, CA 95403-8210
Phone
(707) 544-3400
NPI assigned
Apr 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
College Health Registered Nurse 163WC1400X 95366693 CA
Nurse Practitioner 363L00000X 95039154 CA Primary

Addresses

Primary practice location

208 Concourse Blvd
Santa Rosa, CA 95403-8210

Mailing address

1501 Mendocino Ave
Student Health Services
Santa Rosa, CA 95401-4332
Phone (707) 524-1717

Other practice location 1

1501 Medocino Avenue
Student Health Services
Santa Rosa, CA 95401
Phone (707) 524-1513

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
I20260520002995 CA Practitioner - Nurse Practitioner 0446729248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Redwood Orthopaedic Surgery Associates AMCGroup PAC ID 1850336157, 12 clinicians

Practice addresses (Care Compare)

208 Concourse Blvd
Suite 1
Santa Rosa, CA 95403-8210
Phone (707) 544-3400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95366693CAMDCollege Health Registered Nurse
95039154CAMDNurse Practitioner

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": "1744761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1912793977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 MENDOCINO AVE",
            "address_2": "STUDENT HEALTH SERVICES",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014332",
            "telephone_number": "707-524-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 CONCOURSE BLVD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954038210",
            "telephone_number": "707-544-3400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 Medocino Avenue",
            "address_2": "Student Health Services",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "95401",
            "country_code": "US",
            "telephone_number": "707-524-1513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OHKUBO",
        "first_name": "ANANDI",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-16",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, College Health",
            "state": "CA",
            "license": "95366693",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95039154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.