Individual provider Active NPI

Ejiofor Anthony Darrell Ezekwe Jr.

  • Pediatric Allergy/Immunology Physician
  • Bethesda, MD
National Provider Identifier
1053809186
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Allergy/Immunology PhysicianTaxonomy code 2080P0201X
License
MD049272 Issued in DC
Practice address
10 Center Dr
Bethesda, MD 20892-4220
Phone
(240) 539-8378
NPI assigned
Apr 24, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Allergy/Immunology Physician 2080P0201X D0102616 MD
Pediatric Allergy/Immunology Physician 2080P0201X MD049272 DC Primary

Addresses

Primary practice location

10 Center Dr
Bethesda, MD 20892-4220

Mailing address

8348 Silver Trumpet Dr
Columbia, MD 21045-5635
Phone (410) 790-4884

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
I20250521003023 MD Practitioner - Pediatric Medicine 2961767298 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD049272DCMDPediatric Allergy/Immunology Physician
D0102616MDMDPediatric Allergy/Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University CurrentSince Jul 1, 2025 Accepting new patients
Johns Hopkins University Current Accepting new patients
Johns Hopkins University Pediatric Allergy/Immunology CurrentSince Jul 1, 2025 Accepting new patients

Locations

4940 Eastern Ave
Baltimore, MD 21224

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

Interoperability endpoints

  • Direct secure messaging: eezekwe852323@direct.hopkinsmedicine.org

Organizations & group practices 3

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": "1524528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1053809186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8348 SILVER TRUMPET DR",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210455635",
            "telephone_number": "410-790-4884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CENTER DR",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208924220",
            "telephone_number": "240-539-8378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZEKWE",
        "first_name": "EJIOFOR",
        "middle_name": "ANTHONY DARRELL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-24",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "MD",
            "license": "D0102616",
            "primary": false
        },
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "DC",
            "license": "MD049272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.