MARY ENYI UDENGWU
NPI 1770816373
Nurse Practitioner - Psychiatric/Mental Health in Culver City, CA

Q: What is Mary Udengwu's NPI number?

The NPI number for Mary Udengwu is 1770816373. It was assigned to this individual provider in the NPPES registry on September 14, 2009.

Q: What is Mary Udengwu's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Mary Udengwu was last updated on December 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.

Active since September 14, 2009PECOS Enrolled

9808 VENICE BLVD STE 700, CULVER CITY, CA 90232(310) 945-3350(310) 945-3356 Get Directions Write a Review

NPPES record last updated: December 7, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mary Enyi Udengwu NPPES

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

MARY ENYI UDENGWU (NPI 1770816373) is an individual psychiatric/mental health provider in Culver City, California, licensed in California (19405) and active in the NPI registry since September 2009. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2009).

NPPES Registry Identity

NPI1770816373

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameMARY ENYI UDENGWU

Location Address9808 VENICE BLVD STE 700Culver City, CA 90232-6824

Mailing Address1200 N State StLos Angeles, CA 90089-1001 · (424) 338-2500

Phone(310) 945-3350

Fax(310) 945-3356

Sole ProprietorYes

Medical School CMSOtherGraduated 2009

Enumeration DateSeptember 14, 2009

Last NPPES UpdateDecember 7, 2023

NPPES CertifiedDecember 7, 2023

✔ NPI 1770816373 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in CA · 19405

9808 VENICE BLVD STE 700, Culver City, CA 90232

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Secondary Practice Locations 2

Location 14411 E Kings Canyon RdFresno, CA 93702-3604 · Phone (559) 453-1008 · Fax (559) 512-8705

Location 2265 S Anita Dr Ste 102-104Orange, CA 92868-3355 · Phone (714) 410-3500 · Fax (714) 410-3526

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary Enyi Udengwu is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7315445517

PECOS Enrollment IDI20250807002199

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90232 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KEVIN JACOB WINSTON

Rehabilitation Practitioner