Individual provider Active NPI

Stella Obiageri Kpaduwa, M.D.

  • Pediatrics Physician
  • City of Industry, CA
National Provider Identifier
1992872550
Registry record updated Mar 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A056261 Issued in CA
Practice address
16008 Amar Road
City of Industry, CA 91744-2203
Phone
(626) 330-9535
Fax
(626) 330-2661
NPI assigned
Nov 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A056261 CA Primary

Addresses

Primary practice location

16008 Amar Road
City of Industry, CA 91744-2203

Mailing address

15913 Amar Rd
La Puente, CA 91744-2200
Phone (626) 330-9535

Other identifiers 1

IdentifierTypeStateIssuer
GR0085700MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A056261CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emanate Health Medical Center Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients
Ahmc Greater El Monte Comm Hosp LLC Past Accepting new patients
Julius C Kpaduwa Medical Corporation Past Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521072000000",
    "number": "1992872550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15913 AMAR RD",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917442200",
            "telephone_number": "626-330-9535",
            "fax_number": "626-330-2661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16008 AMAR ROAD",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917442203",
            "telephone_number": "626-330-9535",
            "fax_number": "626-330-2661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KPADUWA",
        "first_name": "STELLA",
        "middle_name": "OBIAGERI",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2018-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A056261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0085700",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in City of Industry, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.