NPIMap

Individual provider Active NPI

Enyinnaya Ugochukwu Abarikwu, MD

  • Internal Medicine Physician
  • Tyler, TX
National Provider Identifier
1174788178
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
P5317 Issued in TX
Practice address
800 E Dawson St
Tyler, TX 75701-2036
Phone
(903) 606-7264
Fax
(903) 525-1254
NPI assigned
Jul 20, 2008
Last updated
Sep 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X P5317 TX Primary
Hospitalist Physician 208M00000X 68252 WI
Hospitalist Physician 208M00000X P5317 TX

Addresses

Primary practice location

800 E Dawson St
Tyler, TX 75701-2036

Mailing address

W3985 County Road NN
Elkhorn, WI 53121-4337
Phone (262) 741-2000

Other practice location 1

W3985 County Road Nn
Elkhorn, WI 53121-4337
Phone (262) 741-2000

Other identifiers 2

IdentifierTypeStateIssuer
325255304MedicaidTX
P02600064OtherTXMCRR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130903000476 TX Practitioner - Internal MedicinePractitioner - Hospitalist 4385817386 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Texas Physician Services, PLLCGroup PAC ID 6305295429, 236 clinicians

Practice addresses (Care Compare)

800 E Dawson St
Tyler, TX 75701-2036
Phone (903) 593-8441

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P5317TXMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tyler Physician Services, PLLC Hospitalist CurrentSince Jun 29, 2024 Accepting new patients
Christus Trinity Clinic Texas Internal Medicine CurrentSince Dec 6, 2020 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Dec 6, 2020 Accepting new patients
North Texas Physician Services, PLLC Internal Medicine CurrentSince Apr 1, 2024 Accepting new patients
Redmond Hospital Services LLC Past Accepting new patients

Locations

700 E Marshall Ave
Longview, TX 75601
Phone (903) 236-2000

811 S Washington Ave
Marshall, TX 75670
Phone (903) 315-1488

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

800 E Dawson St
Fl 4
Tyler, TX 75701
Phone (903) 531-4080

Organizations & group practices 5

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 7

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": "1216512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1174788178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W3985 COUNTY ROAD NN",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531214337",
            "telephone_number": "262-741-2000",
            "fax_number": "262-741-2199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E DAWSON ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012036",
            "telephone_number": "903-606-7264",
            "fax_number": "903-525-1254"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "W3985 County Road Nn",
            "address_purpose": "LOCATION",
            "city": "Elkhorn",
            "state": "WI",
            "postal_code": "531214337",
            "country_code": "US",
            "telephone_number": "262-741-2000",
            "fax_number": "262-741-2199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABARIKWU",
        "first_name": "ENYINNAYA",
        "middle_name": "UGOCHUKWU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-20",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "P5317",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WI",
            "license": "68252",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "P5317",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "325255304",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCRR",
            "identifier": "P02600064",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.