Individual provider Active NPI

Ben O Umeze, MD

  • General Practice Physician
  • Bronx, NY
National Provider Identifier
1023135100
Registry record updated Sep 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
152816 Issued in NY
Practice address
1423 Glover Street
Bronx, NY 10462-4919
Phone
(718) 597-8383
Fax
(718) 892-0234
NPI assigned
Mar 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X 152816 NY
General Practice Physician 208D00000X 152816 NY Primary

Addresses

Primary practice location

1423 Glover Street
Bronx, NY 10462-4919

Mailing address

1423 Glover Street
Bronx, NY 10462-4919
Phone (718) 597-8383

Other identifiers 1

IdentifierTypeStateIssuer
00928074MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20100329000577 NY Practitioner - Preventive MedicinePractitioner - Family PracticePractitioner - General Practice 1951437094 Practice locations: Bronx, NY

Care Compare profile

Medicare Care Compare
Specialty
Preventive MedicineAlso: Family Practice, General Practice
Education
Columbia University College of Physicians and Surgeons, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1423 Glover St
Bronx, NY 10462-4919
Phone (718) 597-8383

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
152816NYMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Brooklyn Medical GP LLC Past Accepting new patients
Lovina Medical PC 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410134400000",
    "number": "1023135100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1423 GLOVER STREET",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104624919",
            "telephone_number": "718-597-8383",
            "fax_number": "718-892-0234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 GLOVER STREET",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104624919",
            "telephone_number": "718-597-8383",
            "fax_number": "718-892-0234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UMEZE",
        "first_name": "BEN",
        "middle_name": "O",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2014-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "NY",
            "license": "152816",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "152816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00928074",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.