Individual provider Active NPI

Augustine Njoku, M.D.

  • Cardiovascular Disease Physician
  • Tyler, TX
National Provider Identifier
1174784904
Registry record updated Aug 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
P5215 Issued in TX
Practice address
2608 McDonald Rd
Tyler, TX 75701-5934
Phone
(903) 595-5514
Fax
(903) 262-3707
NPI assigned
Jun 24, 2008
Last updated
Aug 28, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 204576 LA
Cardiovascular Disease Physician 207RC0000X P5215 TX Primary

Addresses

Primary practice location

2608 McDonald Rd
Tyler, TX 75701-5934

Mailing address

2608 McDonald Rd
Tyler, TX 75701-5934
Phone (903) 595-5514

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160706000158 LA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 7517262918 Reassigns benefits to 1 organization
I20190814002162 TX Practitioner - Cardiovascular Disease (Cardiology) 7517262918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians
Quitman Hospital LLCGroup PAC ID 9133484330, shared by 6 NPIs, 29 clinicians
Pittsburg Hospital LLCGroup PAC ID 5597029272, shared by 3 NPIs, 16 clinicians

Practice addresses (Care Compare)

1000 E 5TH St
Suite 300
Tyler, TX 75701-3333
Phone (903) 590-5080

1000 E 5TH St
Suite 400
Tyler, TX 75701-3362
Phone (903) 596-3500

1000 S Beckham Ave
Tyler, TX 75701-1908
Phone (903) 590-5611

117 N Winnsboro St
Quitman, TX 75783-2144
Phone (903) 763-6220

11937 US Hwy 271
Tyler, TX 75708-3154
Phone (903) 592-6901

18118 FM 344
Flint, TX 75762-6010
Phone (903) 825-3292

2000 S Palestine St
Athens, TX 75751-5610
Phone (903) 676-1000

2608 McDonald Rd
Tyler, TX 75701-5934
Phone (903) 595-5514

2701 US Hwy 271 N
Pittsburg, TX 75686-4289
Phone (903) 946-5442

300 Wilson St
Henderson, TX 75652-5956
Phone (903) 655-6536

3219 E Grande Blvd
Tyler, TX 75707-1407
Phone (903) 283-9700

409 Cottage Rd
Carthage, TX 75633-1466
Phone (903) 694-4790

501 S Ragsdale St
Jacksonville, TX 75766-2434
Phone (903) 541-5143

701 Olympic Plaza Cir
Tyler, TX 75701-1950
Phone (903) 531-8109

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting97
Leg revascularization (restoring blood flow)16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
204576LAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lsu Health Sciences Center Shreveport Faculty Group Practice CurrentSince Dec 1, 2016 Accepting new patients
Etmc Physician Group Inc. CurrentSince Jul 1, 2019 Accepting new patients
Etmc Physician Group Inc. Cardiovascular Disease CurrentSince Jul 1, 2019 Accepting new patients
Starks Medical Past Accepting new patients
Pittsburg Hospital LLC Past Accepting new patients
Quitman Hospital LLC Past Accepting new patients

Locations

1501 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0434

1501 Kings Hwy
Rm 1201
Shreveport, LA 71103
Phone (318) 675-4881

1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287

1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402

409 Cottage Rd
Carthage, TX 75633
Phone (903) 693-3841

704 Davis St
Carthage, TX 75633
Phone (903) 694-4824

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

2701 US Highway 271 N
Pittsburg, TX 75686
Phone (903) 946-5000

2401 Sse Loop 323
Tyler, TX 75701
Phone (903) 510-7212

2608 McDonald Rd
Tyler, TX 75701
Phone 903595551487262

Interoperability endpoints

  • Direct secure messaging: anjoku355555@ahs.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1174784904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2608 MCDONALD RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757015934",
            "telephone_number": "903-595-5514",
            "fax_number": "903-262-3707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2608 MCDONALD RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757015934",
            "telephone_number": "903-595-5514",
            "fax_number": "903-262-3707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NJOKU",
        "first_name": "AUGUSTINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-24",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "LA",
            "license": "204576",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "P5215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.