Individual provider Active NPI

Efem E Imoke, M.D.

  • Surgery Physician
  • Baltimore, MD
National Provider Identifier
1013995216
Registry record updated Jan 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
22450 Issued in MS
Practice address
9601 Pulaski Park Dr
Suite 416
Baltimore, MD 21220-1409
Phone
(410) 933-5678
Fax
(410) 238-7451
NPI assigned
Jan 6, 2006
Last updated
Jan 3, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 22450 MS Primary

Addresses

Primary practice location

9601 Pulaski Park Dr
Suite 416
Baltimore, MD 21220-1409

Mailing address

9601 Pulaski Park Dr
Suite 416
Baltimore, MD 21220-1409
Phone (410) 933-5678

Other identifiers 1

IdentifierTypeStateIssuer
05251568MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20050421000279 MD Practitioner - Physical Medicine and Rehabilitation 5294773107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients
Universal Surgical Center Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451779200000",
    "number": "1013995216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9601 PULASKI PARK DR",
            "address_2": "SUITE 416",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212201409",
            "telephone_number": "410-933-5678",
            "fax_number": "410-238-7451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 PULASKI PARK DR",
            "address_2": "SUITE 416",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212201409",
            "telephone_number": "410-933-5678",
            "fax_number": "410-238-7451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMOKE",
        "first_name": "EFEM",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-06",
        "last_updated": "2016-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MS",
            "license": "22450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05251568",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.