Ndika Fomukong, P.A.C
NPI 1497700066ActiveIndividual· Nurse Practitioner, Primary Care· Van Nuys, CA
Nurse Practitioner, Primary Care (P.A.C) in Van Nuys, California, licensed in CA, with an NPI issued in May 2006. Part D covered 85 prescriptions written in 2024, 94% of them generic.
Overview
| NPI | 1497700066 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | P.A.C |
| Sole proprietor | No |
| NPI issued | May 23, 2006 |
| Last updated in NPPES | Apr 10, 2026 |
| Certified by provider | Apr 10, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Primary Care Primary | 363LP2300X | NP 17180 | CA |
| Physician Assistant | 363A00000X | PA17839 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (CA) |
|---|
Part D prescriptions in 2024
| Prescriptions (claims) | 85 · 156 30-day fills |
|---|---|
| Patients | 17 |
| Total drug cost | $6,093 |
| Generic share | 94% of claims |
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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