Ifeatu Uchenna Oti, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

N5305 Issued in TX

Practice address

1133 Medical Dr
Tyler, TX 75701-2130

Phone

(903) 595-5486

Fax

(903) 595-5128

NPI assigned

Mar 14, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Ifeatu Uchenna Gbulie Former name

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

NephrologyAlso: Internal Medicine

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Tyler Nephrology Associates PAGroup PAC ID 6901862242, 27 clinicians

Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• RCG Mineola Dialysis Dialysis facility, Mineola, TX, CCN 452849
• Fresenius Medical Care Tyler Home Dialysis Dialysis facility, Tyler, TX, CCN 452882
• Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102
• Ut Health East Texas Tyler Regional Hospital Hospital, Tyler, TX, CCN 450083
• Ut Health East Texas Jacksonville Hospital Hospital, Jacksonville, TX, CCN 450194
• Ut Health East Texas Athens Hospital Hospital, Athens, TX, CCN 450389
• Ut Health East Texas Henderson Hospital Hospital, Henderson, TX, CCN 450475

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• NM HMO C-SNP

Interoperability endpoints

• Direct secure messaging: ioti355530@ahs.direct-ci.com
• Direct secure messaging: ioti32265@direct.acumenmd.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Etmc Physician Group Inc.

  • Cardiovascular Disease Physician
  • Tyler, TX
  • NPI 1609382662
  Medicare reassignment Care Compare group NPD
• Tyler Nephrology Associates, P.a.

  dba The Centers For Kidney Care

  • Nephrology Physician
  • Tyler, TX
  • NPI 1942360326
  Medicare reassignment Care Compare group NPD
• Etmc Physician Group Inc.

  • Rural Health Clinic/Center
  • Chandler, TX
  • NPI 1235706581
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• RCG East Texas, LLP

  dba Renal Care Group Mineola

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Mineola, TX
  • NPI 1326150202

  Dialysis facility

  Care Compare affiliation Name & address match
• Renal Care Group Texas, Inc.

  dba Fresenius Medical Care Tyler Home Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Tyler, TX
  • NPI 1194837070

  Dialysis facility

  Care Compare affiliation Name & address match
• Athens Hospital, LLC

  • General Acute Care Hospital
  • Athens, TX
  • NPI 1417465824
  Care Compare affiliation
• Henderson Hospital, LLC

  dba UTHealth East Texas Henderson Hospital

  • General Acute Care Hospital
  • Henderson, TX
  • NPI 1326546797
  Care Compare affiliation
• Jacksonville Hospital LLC

  dba UTHealth East Texas Jacksonville Hospital

  • General Acute Care Hospital
  • Jacksonville, TX
  • NPI 1730697350
  Care Compare affiliation
• Mother Frances Hospital Regional Health Care Center

  dba Christus Mother Frances Hospital Tyler

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1679578439
  Care Compare affiliation
• Tyler Regional Hospital LLC

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1407364847
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1003087388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 MEDICAL DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012130",
            "telephone_number": "903-595-5486",
            "fax_number": "903-595-5128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 MEDICAL DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012130",
            "telephone_number": "903-595-5486",
            "fax_number": "903-595-5128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTI",
        "first_name": "IFEATU",
        "middle_name": "UCHENNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-14",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OK",
            "license": "34742",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "SD",
            "license": "7363",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OH",
            "license": "35.086016",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "N5305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2108011-01",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200280780 A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IFEATU",
            "last_name": "GBULIE",
            "middle_name": "UCHENNA",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christiana C Osuagwu, FNP
• Obiyo O Osuchukwu, MBBCH MPH
• Virginia Oswald
• Queenette Chimeucheya Otamiri
• Christopher Lawrence Otero, CRNFA
• Sharon Overall, DPM
• Troy D Overbeek, DPM
• Hali Overturf
• Aimee Renee Owens, RBT
• Chelsea Owens, PTA

• Nephrology Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Nephrology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.