KENNETH EZENWA (RN) – Psychiatric/Mental Health Nurse Practitioner, NPI 1003379959
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
16,360 NURSE PRACTITIONER in CA
Provider Addresses for KENNETH EZENWA (RN)
17467 HONEY MAPLE ST
CANYON COUNTRY, CA 913876870
Phone: (661) 212-5273
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 41 Open Payments records for all available years, with a total value of $938.
Total Amount is formed as General ($938) + Research ($0) + Ownership ($0) = $938.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($419).
Total Amount
$938
General + Research + Ownership
Payments
41
Total payment records
General Amount
$938
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Janssen Pharmaceuticals, Inc | $419 |
| Otsuka America Pharmaceutical, Inc. | $126 |
| Lundbeck LLC | $118 |
| Alkermes, Inc. | $85 |
| Neurocrine BioSciences Inc. | $52 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-05-06
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20220506002213 | I | Nurse Practitioner | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 96 | 18 | $0 |
| 90792 | Psychiatric diagnostic evaluation with medical services | 18 | 18 | $0 |
Insurance plans in this area (ZIP 91387)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Marriage And Family Therapist | CA | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | CA | |
| Clinical Social Worker | CA | |
| Clinical Social Worker | CA | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | CA | |
| P S Y C H I A T R Y | MI | |
| Nurse Practitioner | CA |
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