KENNETH EJIOGU
NPI 1639647019
Nurse Practitioner - Family in Los Angeles, CA
About Kenneth Ejiogu NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KENNETH EJIOGU (NPI 1639647019) is an individual family provider in Los Angeles, California, licensed in California (95011746) and active in the NPI registry since November 2018. He is enrolled in Medicare PECOS, maintains a secondary practice location in Rancho Cucamonga, and is a graduate of Other (2017).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Kenneth Ejiogu is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
3Medicare enrollment records show Kenneth Ejiogu reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Los Angeles, CA 90017
- Reassigned Medicare billing, California enrollment
- 109 clinicians in this Medicare group
Los Angeles, CA 90015
- Reassigned Medicare billing, California enrollment
- 2,052 clinicians in this Medicare group
Visalia, CA 93277
- Reassigned Medicare billing, California enrollment
- 30 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 10
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 90017 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 7
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
LOS ANGELES, CA 90017
LOS ANGELES, CA 90017
LOS ANGELES, CA 90017
LOS ANGELES, CA 90017
LOS ANGELES, CA 90017
LOS ANGELES, CA 90017
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 Kenneth Ejiogu's NPI number?
The NPI number for Kenneth Ejiogu is 1639647019. It was assigned to this individual provider in the NPPES registry on November 5, 2018.
Where is Kenneth Ejiogu located?
Kenneth Ejiogu practices at 1127 Wilshire Blvd Ste 800, Los Angeles, CA 90017. The listed phone number is (213) 839-1119.
What is Kenneth Ejiogu's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Kenneth Ejiogu enrolled in Medicare?
Yes. Kenneth Ejiogu is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Kenneth Ejiogu's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kenneth Ejiogu reassigns Medicare benefits to 3 organizations: Algos Inc., A Medical Corporation (Los Angeles, CA), Healthcare Partners Affiliates Medical Group (Los Angeles, CA) and Pain Clinics Of Central California, Inc. (Visalia, CA). Each 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 Kenneth Ejiogu's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kenneth Ejiogu was last updated on April 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# Kenneth Ejiogu · NPI 1639647019
Family physician in Los Angeles, California. Individual provider, active in the CMS NPPES registry since November 5, 2018.
## Identity
- **NPI:** 1639647019 (Entity type: Individual)
- **Enumerated:** November 5, 2018
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 95011746 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1127 WILSHIRE BLVD STE 800, Los Angeles, CA 90017-3909
- **Phone:** (213) 839-1119
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Algos Inc., A Medical Corporation (NPI 1649612094, Los Angeles, CA); Healthcare Partners Affiliates Medical Group (NPI 1659312593, Los Angeles, CA); Pain Clinics Of Central California, Inc. (NPI 1861060733, Visalia, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2017
## Record status
- **NPPES last updated:** April 8, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1639647019) · Data from the CMS NPPES public registry.