Active NPI
Anandi S Ohkubo
- Nurse Practitioner
- Santa Rosa, CA
National Provider Identifier
1912793977
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 95039154
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 95366693 | CA | MD | College Health Registered Nurse |
| 95039154 | CA | MD | Nurse 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.
-
- Specialist
- Santa Rosa, CA
- NPI 1215023056
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.