Individual provider Active NPI

Obumneke Jessica Ugbor, PA-C

  • Physician Assistant
  • Mesa, AZ
National Provider Identifier
1992373906
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8409 Issued in AZ
Practice address
1910 S Stapley Dr Ste 209
Mesa, AZ 85204-6679
Phone
(480) 351-8020
NPI assigned
Jun 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 8409 AZ Primary
Physician Assistant 363A00000X PA14404 TX

Addresses

Primary practice location

1910 S Stapley Dr Ste 209
Mesa, AZ 85204-6679

Mailing address

1910 S Stapley Dr Ste 209
Mesa, AZ 85204-6679
Phone (480) 351-8020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20250827004551 AZ Practitioner - Physician Assistant 3870094345 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Care Center LLCGroup PAC ID 5991064420, 703 clinicians

Practice addresses (Care Compare)

1910 S Stapley Dr
Suite 209
Mesa, AZ 85204-6679
Phone (888) 362-5953

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA14404TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Center, LLC Physician Assistant CurrentSince Jun 14, 2025 Accepting new patients
Fusion Family Consulting PastSince Jul 10, 2022 Accepting new patients

Locations

1910 S Stapley Dr
Ste 209
Mesa, AZ 85204
Phone (480) 351-8020

Organizations & group practices 2

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": "1623715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1992373906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 S STAPLEY DR STE 209",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852046679",
            "telephone_number": "480-351-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 S STAPLEY DR STE 209",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852046679",
            "telephone_number": "480-351-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UGBOR",
        "first_name": "OBUMNEKE",
        "middle_name": "JESSICA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-15",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "8409",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA14404",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.