NPIMap

Individual provider Active NPI

Mbanefo Ojukwu, MD

  • Internal Medicine Physician
  • Westlake, OH
National Provider Identifier
1083765481
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.081482 Issued in OH
Practice address
29000 Center Ridge Rd
Westlake, OH 44145-5293
Phone
(440) 835-8000
NPI assigned
Jan 15, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35.081482 OH Primary

Addresses

Primary practice location

29000 Center Ridge Rd
Westlake, OH 44145-5293

Mailing address

147 Mallard Creek Run
Lagrange, OH 44050-9803
Phone (440) 458-5827

Other identifiers 1

IdentifierTypeStateIssuer
2510885MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040528001341 OH Practitioner - Internal Medicine 2769463256 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fisher-Titus Medical Care LLCGroup PAC ID 6507940566, 82 clinicians

Practice addresses (Care Compare)

24 Hyde St
Wakeman, OH 44889-9301
Phone (440) 839-2226

Hospital & facility affiliations

  • Fisher-Titus Hospital Hospital, Norwalk, OH, CCN 360065
  • Uh Cleveland Medical Center Hospital, Cleveland, OH, CCN 360137

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.081482OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fisher-Titus Medical Center Current Accepting new patients
Hospitalist Medicine Physicians of Ashland County, LTD. Internal Medicine Past Accepting new patients
Hospital Medicine Associates of Ohio Professional Corporation Internal Medicine Past Accepting new patients

Locations

272 Benedict Ave
Norwalk, OH 44857
Phone (419) 668-1341

Organizations & group practices 6

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 5

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": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083765481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 MALLARD CREEK RUN",
            "city": "LAGRANGE",
            "state": "OH",
            "postal_code": "440509803",
            "telephone_number": "440-458-5827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29000 CENTER RIDGE RD",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455293",
            "telephone_number": "440-835-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OJUKWU",
        "first_name": "MBANEFO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.081482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2510885",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake, OH

Sources for this page

Verify at the official NPI Registry.