Benedicta Umoru, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036100162 Issued in IL

Practice address

5032 N Illinois St
Ste B
Fairview Heights, IL 62208-3415

Phone

(618) 416-9005

Fax

(618) 641-9452

NPI assigned

Jul 20, 2006

Last updated

May 13, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IL

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

Internal Medicine

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital Hospital, Belleville, IL, CCN 140185

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HCAEAD/Endpoint/HCAEAD

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

• Heartland Medical Center LLC

  • Internal Medicine Physician
  • Fairview Heights, IL
  • NPI 1912927351
  Medicare reassignment NPD Authorized official
• Cardiology Consultants LTD

  • Cardiovascular Disease Physician
  • Belleville, IL
  • NPI 1821015819
  NPD (past)
• Southern Illinois Regional Wellness Center

  • Federally Qualified Health Center (FQHC)
  • East Saint Louis, IL
  • NPI 1336258540
  NPD (past)

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

• Protestant Memorial Medical Center, Inc.

  dba Memorial Hospital

  • General Acute Care Hospital
  • Belleville, IL
  • NPI 1982796181
  Care Compare affiliation

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463097600000",
    "number": "1003836446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2015",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622080215",
            "telephone_number": "618-355-9970",
            "fax_number": "618-355-9972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5032 N ILLINOIS ST",
            "address_2": "STE B",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622083415",
            "telephone_number": "618-416-9005",
            "fax_number": "618-641-9452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UMORU",
        "first_name": "BENEDICTA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2016-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036100162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IL",
            "identifier": "08232145",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036100162",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00248272",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anastasia Tukhtina
• Brittany Renae Turner
• Dawne Akilah Turner
• Melinda Raye Turner, D.C.
• Ty Parker DMD PC (Fountains Family Dentistry)
• Urology of St. Louis, Inc.
• Usv Optical Inc.
• Lynette Vanausdale, PTA
• Lars E Vardaman, PHARM D
• Vep Il Optometric LLC (All About Eyes)

• Internal Medicine Physician in Fairview Heights, IL
• Providers in Fairview Heights, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2016; 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.