Individual provider Active NPI

Chibuzo Onyeze Ukaegbu, MD, MPH

  • Addiction Medicine (Family Medicine) Physician
  • Las Cruces, NM
National Provider Identifier
1104011444
Registry record updated Jun 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
License
MD2008-0255 Issued in NM
Practice address
3885 Foothills Rd
Suite B
Las Cruces, NM 88011-4672
Phone
(575) 556-9837
Fax
(575) 652-3213
NPI assigned
Sep 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD 2008-0255 NM
Addiction Medicine (Family Medicine) Physician 207QA0401X MD2008-0255 NM Primary

Addresses

Primary practice location

3885 Foothills Rd
Suite B
Las Cruces, NM 88011-4672

Mailing address

PO Box 13969
Las Cruces, NM 88013-3969

Other identifiers 1

IdentifierTypeStateIssuer
50538756MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20090519000682 NM Practitioner - Family PracticePractitioner - Addiction Medicine 1759430812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Addiction Medicine
Education
Other, 1996
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3885 Foothills Rd
Suite B
Las Cruces, NM 88011-4672
Phone (575) 556-9837

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 2008-0255NMMDFamily Medicine Physician
MD2008-0255NMMDAddiction Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Buzyke Alliance LLC CurrentSince Jun 13, 2014 Accepting new patients

Locations

1212 9th St
Ste D
Alamogordo, NM 88310
Phone (505) 437-8022

3885 Foothills Rd
Ste B
Las Cruces, NM 88011
Phone (505) 521-3388

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": "1189382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529366400000",
    "number": "1104011444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13969",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880133969",
            "fax_number": "575-652-3213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3885 FOOTHILLS RD",
            "address_2": "SUITE B",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114672",
            "telephone_number": "575-556-9837",
            "fax_number": "575-652-3213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UKAEGBU",
        "first_name": "CHIBUZO",
        "middle_name": "ONYEZE",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-10",
        "last_updated": "2018-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD 2008-0255",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "NM",
            "license": "MD2008-0255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50538756",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.