Individual provider Active NPI

Toritsetimiyin Marian E-Nunu, M.D., MPH

  • Urology Physician
  • Fort Cavazos, TX
National Provider Identifier
1083027189
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD-18334 Issued in HI
Practice address
590 Medical Center Rd
Surgery Dept, Urology Clinic
Fort Cavazos, TX 76544
Phone
(254) 288-8007
Fax
(254) 288-8875
NPI assigned
Jun 5, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X A141063 CA
Urology Physician 208800000X MD-18334 HI Primary

Addresses

Primary practice location

590 Medical Center Rd
Surgery Dept, Urology Clinic
Fort Cavazos, TX 76544

Mailing address

590 Medical Center Rd
Surgery Dept, Urology Clinic
Fort Cavazos, TX 76544
Phone (254) 288-8007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20231121000340 MN Practitioner - Urology 3072961697 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Astera HealthGroup PAC ID 2961395272, shared by 8 NPIs, 106 clinicians

Practice addresses (Care Compare)

4 Deerwood Ave NW
Wadena, MN 56482-1253
Phone (218) 631-1360

415 Jefferson St N
Wadena, MN 56482-1264
Phone (218) 631-7495

415 Jefferson St N
Wadena, MN 56482-1296

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A141063CAMDUrology Physician
MD-18334HIMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Astera Health Current Accepting new patients
Astera Health CurrentSince Nov 1, 2023 Accepting new patients
Astera Health CurrentSince Nov 1, 2023 Accepting new patients

Locations

421 11th St NW
Wadena, MN 56482
Phone (218) 631-3510

415 Jefferson St N
Wadena, MN 56482
Phone (218) 631-3510

Interoperability endpoints

  • Direct secure messaging: tenunu756481@direct.centracare.com

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.

Hospital & facility affiliations 3

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": "1401926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1083027189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 MEDICAL CENTER RD",
            "address_2": "SURGERY DEPT, UROLOGY CLINIC",
            "city": "FORT CAVAZOS",
            "state": "TX",
            "postal_code": "76544",
            "telephone_number": "254-288-8007",
            "fax_number": "254-288-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 MEDICAL CENTER RD",
            "address_2": "SURGERY DEPT, UROLOGY CLINIC",
            "city": "FORT CAVAZOS",
            "state": "TX",
            "postal_code": "76544",
            "telephone_number": "254-288-8007",
            "fax_number": "254-288-8875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "E-NUNU",
        "first_name": "TORITSETIMIYIN",
        "middle_name": "MARIAN",
        "name_prefix": "Dr.",
        "credential": "M.D., MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-05",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "A141063",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "HI",
            "license": "MD-18334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Cavazos, TX

Sources for this page

Verify at the official NPI Registry.