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MONTCLAIR COMMUNITY CLINIC
NPI 1538908074
Internal Medicine in Montclair, CA

Active since May 23, 2024
9655 MONTE VISTA AVE STE 402A, MONTCLAIR, CA 91763(909) 972-0924(909) 966-4987 Get Directions Write a Review

NPPES record last updated: March 11, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 11, 2026, Jan 23, 2026, Sep 11, 2025 (3 updates tracked since 2025).

About Montclair Community Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MONTCLAIR COMMUNITY CLINIC (NPI 1538908074) is a healthcare organization registered as an internal medicine in Montclair, California and active in the NPI registry since May 2024. The organization lists Kenoye R Uku, Owner, as its authorized official.

NPPES Registry Identity

NPI1538908074
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameMONTCLAIR COMMUNITY CLINIC
Location Address9655 MONTE VISTA AVE STE 402AMontclair, CA 91763-2238
Mailing Address9655 Monte Vista Ave Ste 402aMontclair, CA 91763-2238 · (909) 972-0924 · Fax (909) 966-4987
Phone(909) 972-0924
Fax(909) 966-4987
Organization SubpartNo
Authorized OfficialKenoye R UkuOwner · (206) 456-6933
Enumeration DateMay 23, 2024
Last NPPES UpdateMarch 11, 20263 updates tracked since enumeration
NPPES CertifiedMarch 11, 2026
✔ NPI 1538908074 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X
9655 MONTE VISTA AVE STE 402A, Montclair, CA 91763
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Montclair Community Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Montclair Community Clinic, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (4)

Rerhime Uku, PMHNP
Nurse Practitioner
NPI 1659906147
23719 MOULTON PKWY
Laguna Hills, CA 92653
(949) 587-3700
✔ PECOS✔ Accepts Medicare32 mi
Kenoye Uku, MD
Internal Medicine
NPI 1013084920
6041 CADILLAC AVE
Los Angeles, CA 90034
(323) 857-2000
✔ PECOS39 mi
Ese Ogbetuo, FNP
Nurse Practitioner
NPI 1417423138
22617 HAWTHORNE BLVD
Torrance, CA 90505
(310) 370-4700
✔ PECOS✔ Accepts Medicare42 mi
Peter Oziegbe
Nurse Practitioner
NPI 1770753618
4025 W 226TH ST
Torrance, CA 90505
(310) 373-4556
✔ PECOS✔ Accepts Medicare42 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Montclair Community Clinic's NPI number?

The NPI number for Montclair Community Clinic is 1538908074. It was assigned to this organization in the NPPES registry on May 23, 2024.

Where is Montclair Community Clinic located?

Montclair Community Clinic is located at 9655 Monte Vista Ave Ste 402A, Montclair, CA 91763. The listed phone number is (909) 972-0924.

What is Montclair Community Clinic's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Montclair Community Clinic enrolled in Medicare?

Yes. Montclair Community Clinic is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Montclair Community Clinic?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Montclair Community Clinic. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (3) and Internal Medicine (1). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Montclair Community Clinic was last updated on March 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.