Individual provider Active NPI

Chukwuemeka C Ufomadu, MD

  • Internal Medicine Physician
  • Baltimore, MD
National Provider Identifier
1164424545
Registry record updated Aug 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0045925 Issued in MD
Practice address
3100 Towanda Ave
Baltimore, MD 21215-7828
Phone
(410) 298-8223
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2008

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 D0045925 MD Primary

Addresses

Primary practice location

3100 Towanda Ave
Baltimore, MD 21215-7828

Mailing address

2115 Parkside Dr
Mitchellville, MD 20721-4227
Phone (410) 298-8223

Other identifiers 1

IdentifierTypeStateIssuer
224401201MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20050112000185 MD Practitioner - Internal Medicine 1254389687 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Luminis Health Medical Group, LLCGroup PAC ID 2860447315, 540 clinicians

Practice addresses (Care Compare)

1940 W Baltimore St
Baltimore, MD 21223-2245
Phone (410) 362-3616

2001 Medical Pkwy
Annapolis, MD 21401-3280
Phone (443) 481-1000

2003 Medical Pkwy
Annapolis, MD 21401-3081

2003 Medical Pkwy Wayson Pavillion
Advanced Internal Medicine Residenc
Annapolis, MD 21401-3081
Phone (443) 951-4286

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0045925MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Luminis Health Medical Group, LLC Internal Medicine CurrentSince Sep 1, 2010 Accepting new patients
Luminis Health Medical Group, LLC Current Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Sep 1, 2010 Accepting new patients
Anne Arundel Medical Center Inc Past Accepting new patients
Luminis Health Medical Group, LLC Internal Medicine Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2003 Medical Pkwy
Ste 301
Annapolis, MD 21401
Phone (443) 481-3366

2001 Medical Pkwy
Annapolis, MD 21401
Phone (410) 280-5601

Organizations & group practices 7

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 2

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": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218153600000",
    "number": "1164424545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 PARKSIDE DR",
            "city": "MITCHELLVILLE",
            "state": "MD",
            "postal_code": "207214227",
            "telephone_number": "410-298-8223",
            "fax_number": "410-298-8225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 TOWANDA AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212157828",
            "telephone_number": "410-298-8223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UFOMADU",
        "first_name": "CHUKWUEMEKA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2008-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0045925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "224401201",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.