MRS. NGOZI EDITH EBOKA – Family Nurse Practitioner, NPI 1669995494

MRS. NGOZI EDITH EBOKA is a healthcare provider. based in Menifee, California. specializing in NURSE PRACTITIONER. They hold a License No. 95006789 (CA). The NPI Number for MRS. NGOZI EDITH EBOKA is 1669995494

Main info

Female
9 Years Of Experience
Accepts Medicare Assignment
Name
MRS. NGOZI EDITH EBOKA
NPI
1669995494
Phone
(909) 205-1663
Address
29833 TWIN LAKES RD
Enumeration Date
24 July 2017
Last Update Date
16 December 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9513532000
Graduation Year
2017 (9 years ago)
PAC ID
4183962624
Group Practice PAC ID
6002729175
Professional Enrollment ID
I20190208000697
Address ID
CA925053043RI10800AVEX300

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness85
Years active:8State licenses:1Other namesUpdated within 12 months

16,360 NURSE PRACTITIONER in CA

Provider Addresses for MRS. NGOZI EDITH EBOKA

  • 29833 TWIN LAKES RD

    MENIFEE, CA 925859255

    Phone: (909) 205-1663

    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)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2019-02-08

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190208000697INurse PractitionerCATBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92585)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6002729175View full group profile
NameSpecialtyState
U R O L O G YOH
Nurse PractitionerCA
Internal MedicineCA
Internal MedicineCA
Internal Medicine, GastroenterologyCA
Physician AssistantCA
Emergency MedicineNC
O P H T H A L M O L O G YCA
Anesthesiology, Pain ManagementNH
Family Practice, Sports MedicineCA

Reviews

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Frequently asked questions

Is there an official ID for MRS. NGOZI EDITH EBOKA in U.S. healthcare records?
The official identifier for MRS. NGOZI EDITH EBOKA is NPI 1669995494.
Is MRS. NGOZI EDITH EBOKA still an active registrant?
MRS. NGOZI EDITH EBOKA carries an active NPI according to the public dataset.
What clinical focus is listed for MRS. NGOZI EDITH EBOKA?
At a glance, MRS. NGOZI EDITH EBOKA is tied to Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What practice footprint exists for MRS. NGOZI EDITH EBOKA?
Travel planning: use Menifee, California as the reference point for MRS. NGOZI EDITH EBOKA, then confirm.
When was this NPI issued?
Enumeration for MRS. NGOZI EDITH EBOKA is noted as July 24, 2017 where the registry provides it.

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