DR. EMMANUEL NOSA OBANOR (DO) – Gastroenterology Physician, NPI 1689615007
Gastroenterology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,981 GASTROENTEROLOGY in CA
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Provider Addresses for DR. EMMANUEL NOSA OBANOR (DO)
Jack in the Box, 2425, West Kettleman Lane, Lodi, San Joaquin County, California, 95242, United States
LODI, CA 952419511
Phone: (209) 339-7435
Fax: (209) 333-3054
Type: Mailing
South Fairmont Avenue, Lodi, San Joaquin County, California, 95241, United States
SUITE 125
LODI, CA 952405100
Phone: (209) 334-8514
Fax: (209) 366-2661
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 102 Open Payments records for all available years, with a total value of $2,076.
Total Amount is formed as General ($2,076) + Research ($0) + Ownership ($0) = $2,076.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: ABBVIE INC. ($651).
Total Amount
$2,076
General + Research + Ownership
Payments
102
Total payment records
General Amount
$2,076
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-18
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2009-12-21
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 |
|---|---|---|---|---|
| I20091221000456 | I | Gastroenterology | 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 | 189 | 113 | $0 |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 152 | 58 | $0 |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 117 | 52 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 61 | 61 | $0 |
Insurance plans in this area (ZIP 95241)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| INTERNAL MEDICINE | CA | 43235 | Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope | 11 | 11 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | CA | |
| Diagnostic Radiology, Interventional Radiology | MA | |
| Diagnostic Radiology | CA | |
| - | CA | |
| Orthopedic Surgery | CA | |
| - | WV | |
| Diagnostic Radiology | CA | |
| - | TX | |
| General Surgery | CA | |
| Interventional Radiology, Diagnostic Radiology | IL |
Reviews
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