Individual provider Active NPI

Ebere Nduka, FNP

  • Family Medicine Physician
  • Baltimore, MD
National Provider Identifier
1063987063
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R194646 Issued in MD
Practice address
405 N Paca St FL 1
Baltimore, MD 21201-1815
Phone
(410) 779-9609
Fax
(443) 552-4758
NPI assigned
Oct 5, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X R194646 MD Primary

Addresses

Primary practice location

405 N Paca St FL 1
Baltimore, MD 21201-1815

Mailing address

48 Winters LN
Catonsville, MD 21228-4437
Phone (410) 660-9262

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190617000558 MD Practitioner - Nurse Practitioner 7517290091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

48 Winters LN
Catonsville, MD 21228-4437
Phone (410) 660-9262

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emerald Spring Clinics Single Specialty CurrentSince Dec 26, 2021 Accepting new patients

Locations

405 N Paca St
Baltimore, MD 21201
Phone (443) 410-8818

405 N Paca St
Fl 1
Baltimore, MD 21201
Phone (410) 725-8961

48 Winters Ln
Catonsville, MD 21228
Phone (410) 660-9262

Organizations & group practices 1

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": "1538697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1063987063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 WINTERS LN",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212284437",
            "telephone_number": "410-660-9262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 N PACA ST FL 1",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011815",
            "telephone_number": "410-779-9609",
            "fax_number": "443-552-4758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDUKA",
        "first_name": "EBERE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-05",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "R194646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.