Active NPI
Uchenna Rebecca Ufondu, MD
- Pediatrics Physician
- East Stroudsburg, PA
National Provider Identifier
1124090196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD062320L
- Practice address
- 302 E Brown St
Ste a
East Stroudsburg, PA 18301 - Phone
- (570) 476-4161
- Fax
- (570) 476-9954
- NPI assigned
- Feb 3, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD062320L | PA | Primary |
Addresses
Primary practice location
302 E Brown St
Ste a
East Stroudsburg, PA 18301
Mailing address
302 E Brown St
Ste a
East Stroudsburg, PA 18301
Phone (570) 476-4161
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0016654970004 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD062320L | PA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pocono Adult & Pediatric Medical Group LLC | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- uufondu234626@direct2.lvhn.org
- https://api.platform.athenahealth.com/11514/brand/1/csg/1/fhir/r4
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.
-
- Family Medicine Physician
- East Stroudsburg, PA
- NPI 1144251745
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295568000000",
"number": "1124090196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "302 E BROWN ST",
"address_2": "STE A",
"city": "EAST STROUDSBURG",
"state": "PA",
"postal_code": "18301",
"telephone_number": "570-476-4161",
"fax_number": "570-476-9954"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "302 E BROWN ST",
"address_2": "STE A",
"city": "EAST STROUDSBURG",
"state": "PA",
"postal_code": "18301",
"telephone_number": "570-476-4161",
"fax_number": "570-476-9954"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UFONDU",
"first_name": "UCHENNA",
"middle_name": "REBECCA",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-02-03",
"last_updated": "2011-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MD062320L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0016654970004",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in East Stroudsburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.