Active NPI
Nnamdi Henry Chukwuka, MD
- Cardiovascular Disease Physician
- Brooklyn, NY
National Provider Identifier
1053806802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 1481401
- Practice address
- 4802 10TH Ave
Brooklyn, NY 11219-2916 - Phone
- (718) 283-6000
- NPI assigned
- Jun 25, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 1481401 | ID | Primary |
| Clinical Cardiac Electrophysiology Physician | 207RC0001X | 1481401 | ID |
Addresses
Primary practice location
4802 10TH Ave
Brooklyn, NY 11219-2916
Mailing address
4802 10TH Ave
Brooklyn, NY 11219-2916
Phone (718) 283-6000
Other practice location 1
700 W Ironwood Dr Ste 320
Coeur D Alene, ID 83814-4485
Phone (208) 625-5250
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181203000377 | NY | Order and Referring Only - Internal Medicine | 0042554032 |
Care Compare profile
Medicare Care Compare- Specialty
- Cardiac Electrophysiology
- Education
- Other, 2016
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- nnamdi.chukwuka.p1@direct.mmc.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782864000000",
"number": "1053806802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4802 10TH AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112192916",
"telephone_number": "718-283-6000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4802 10TH AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112192916",
"telephone_number": "718-283-6000"
}
],
"practiceLocations": [
{
"address_1": "700 W Ironwood Dr Ste 320",
"address_purpose": "LOCATION",
"city": "Coeur D Alene",
"state": "ID",
"postal_code": "838144485",
"country_code": "US",
"telephone_number": "208-625-5250",
"fax_number": "208-625-5251",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHUKWUKA",
"first_name": "NNAMDI",
"middle_name": "HENRY",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-06-25",
"last_updated": "2026-07-01",
"certification_date": "2026-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "ID",
"license": "1481401",
"primary": true
},
{
"code": "207RC0001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
"state": "ID",
"license": "1481401",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; 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.