Individual provider Active NPI

Awele N Maduka-Ezeh, MD

  • Internal Medicine Physician
  • Newark, DE
National Provider Identifier
1114130069
Registry record updated Apr 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C1-0009931 Issued in DE
Practice address
200 Hygeia Dr
Suite 2300
Newark, DE 19713-2049
Phone
(302) 623-7362
Fax
(302) 623-0117
NPI assigned
May 8, 2007
Last updated
Apr 26, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT188393 PA
Internal Medicine Physician 207R00000X C1-0009931 DE Primary
Infectious Disease Physician 207RI0200X 104333 MN
Infectious Disease Physician 207RI0200X 52291 MN

Addresses

Primary practice location

200 Hygeia Dr
Suite 2300
Newark, DE 19713-2049

Mailing address

200 Hygeia Dr
Suite 2300
Newark, DE 19713-2049
Phone (302) 623-7362

Other identifiers 1

IdentifierTypeStateIssuer
ENROLLEDMedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20120209000216 DE Practitioner - Internal MedicinePractitioner - Infectious Disease 6002961539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Infectious Disease
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of DelawareGroup PAC ID 6507756731, 3 clinicians

Practice addresses (Care Compare)

417 Federal St
Dover, DE 19901-3635
Phone (302) 744-4548

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT188393PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Delaware CurrentSince Aug 20, 2024 Accepting new patients
State of Delaware Current Accepting new patients

Locations

417 Federal St
Dover, DE 19901
Phone (302) 744-4548

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366934400000",
    "number": "1114130069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HYGEIA DR",
            "address_2": "SUITE 2300",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132049",
            "telephone_number": "302-623-7362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HYGEIA DR",
            "address_2": "SUITE 2300",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132049",
            "telephone_number": "302-623-7362",
            "fax_number": "302-623-0117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADUKA-EZEH",
        "first_name": "AWELE",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2013-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT188393",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C1-0009931",
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MN",
            "license": "104333",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MN",
            "license": "52291",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.