Individual provider Active NPI

Chinedu Obiefule, PA-C

  • Physician Assistant
  • Eldersburg, MD
National Provider Identifier
1073151908
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1211 Liberty Rd
Eldersburg, MD 21784-7927
Phone
(443) 761-9504
NPI assigned
Dec 10, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1211 Liberty Rd
Eldersburg, MD 21784-7927

Mailing address

955 Richmond Rd
East Meadow, NY 11554-4545
Phone (443) 761-9504

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20211110000859 MD Practitioner - Physician Assistant 9335538578 Reassigns benefits to 2 organizations
I20220301000623 DC Practitioner - Physician Assistant 9335538578 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CRH MD Management LLCGroup PAC ID 2466841028, 70 clinicians
Carroll Health Group LLCGroup PAC ID 3870627029, 68 clinicians

Practice addresses (Care Compare)

11804 Reisterstown Rd
Reisterstown, MD 21136-3311
Phone (410) 870-5094

1211 Liberty Rd
Eldersburg, MD 21784-7927
Phone (410) 617-9129

14090 HG Trueman Rd
Suite 1300
Solomons, MD 20688-3151
Phone (410) 394-2800

14421 Baltimore Ave
Laurel, MD 20707-4949
Phone (240) 786-6684

1741 Dual Hwy
Hagerstown, MD 21740-6624
Phone (301) 790-0254

193 Stoner Ave
Suite 220
Westminster, MD 21157-6881
Phone (410) 876-3380

19825 Frederick Rd
Germantown, MD 20876-1309
Phone (240) 801-9944

200 Memorial Ave
Westminster, MD 21157-5726
Phone (410) 848-3000

750 Rockville Pike
Rockville, MD 20852-1133
Phone (301) 424-0658

99 Baughmans LN
Frederick, MD 21702-4904
Phone (301) 662-1392

Hospital & facility affiliations

  • Carroll Hospital Center Hospital, Westminster, MD, CCN 210033

Merit-based Incentive Payment System (MIPS)

Final score
53.05 of 100Reported as group
Quality
49.52
Promoting interoperability
0
Improvement activities
40
Cost
77.32

Merit-based Incentive Payment System (MIPS)

Final score
83.16 of 100Reported as group
Quality
75.05
Promoting interoperability
100
Improvement activities
40
Cost
68.82

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Statcare Group, LLC CurrentSince Nov 4, 2021 Accepting new patients
Carroll Health Group, LLC CurrentSince Nov 1, 2022 Accepting new patients
Paritycare Dda Services Inc Current Accepting new patients
CRH MD Management LLC CurrentSince Dec 1, 2021 Accepting new patients
Hicksville Family Medical Care, PLLC Past Accepting new patients

Locations

590 Lanier Ave W
Fayetteville, GA 30214

14421 Baltimore Ave
#12202
Laurel, MD 20707
Phone (240) 786-6684

14421 Baltimore Ave
Laurel, MD 20707
Phone (240) 786-6684

11804 Reisterstown Rd
Reisterstown, MD 21136
Phone (410) 870-5094

14090 Hg Trueman Rd
Ste 1300
Solomons, MD 20688
Phone (410) 394-2800

1211 Liberty Rd
Sykesville, MD 21784
Phone (410) 617-9129

1220A E Joppa Rd
Ste 109
Towson, MD 21286
Phone (410) 296-0018

193 Stoner Ave
Ste 220
Westminster, MD 21157
Phone (410) 871-2204

200 Memorial Ave
Westminster, MD 21157
Phone (410) 848-3000

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1575936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1073151908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 RICHMOND RD",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115544545",
            "telephone_number": "443-761-9504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 LIBERTY RD",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "217847927",
            "telephone_number": "443-761-9504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBIEFULE",
        "first_name": "CHINEDU",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-10",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eldersburg, MD

Sources for this page

Verify at the official NPI Registry.