Active NPI
Jude Poku, M.D.
- Internal Medicine Physician
- Las Vegas, NV
National Provider Identifier
1205215415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 19315
- Practice address
- 1000 S Rainbow Blvd Ste a
Las Vegas, NV 89145 - Phone
- (702) 952-9171
- Fax
- (702) 952-9136
- NPI assigned
- May 20, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | 19315 | NV | Primary |
| Internal Medicine Physician | 207R00000X | 2023039360 | MO |
Addresses
Primary practice location
1000 S Rainbow Blvd Ste a
Las Vegas, NV 89145
Mailing address
PO Box 98978
Las Vegas, NV 89193-8978
Phone (702) 216-3346
Other practice location 1
3435 Main St
117 Cary Hall
Buffalo, NY 14214-3001
Phone (716) 829-6130
Other practice location 2
3435 Main St
117 Cary Hall
Buffalo, NY 14214-3001
Phone (716) 829-6130
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205215415 | Medicaid | NV | |
| 19315 | Other | NV | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN, MO, FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- State University of New York at Buffalo School of Medicine, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4725 N Federal Hwy
Fort Lauderdale, FL 33308-4603
Phone (954) 771-8000
Hospital & facility affiliations
- Holy Cross Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Honor Physicians, LLC | Current | Accepting new patients | |
| General John J Pershing Memorial Hospital Association | Past | Accepting new patients | |
| Intermountain Medical Holdings Nevada Inc | Internal Medicine | Past | Accepting new patients |
Locations
3809 N Main St
Ste 100
Mishawaka, IN 46545
Phone (574) 520-1700
1736 E Day Rd
Ste 200
Mishawaka, IN 46545
Phone (574) 520-1700
4455 Edison Lakes Pkwy
#100
Mishawaka, IN 46545
Phone (574) 231-6800
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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Fort Lauderdale, FL
- NPI 1417761073
-
- Primary Care Clinic/Center
- Mishawaka, IN
- NPI 1194288860
-
- Internal Medicine Physician
- Henderson, NV
- NPI 1245997279
-
- Critical Access Hospital
- Brookfield, MO
- NPI 1417991159
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Ft Lauderdale, FL
- NPI 1639197395
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703808000000",
"number": "1205215415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 98978",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891938978",
"telephone_number": "702-216-3346",
"fax_number": "702-671-6883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 S RAINBOW BLVD STE A",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "89145",
"telephone_number": "702-952-9171",
"fax_number": "702-952-9136"
}
],
"practiceLocations": [
{
"address_1": "3435 Main St",
"address_2": "117 CARY HALL",
"address_purpose": "LOCATION",
"city": "Buffalo",
"state": "NY",
"postal_code": "142143001",
"country_code": "US",
"telephone_number": "716-829-6130",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3435 Main St",
"address_2": "117 CARY HALL",
"address_purpose": "LOCATION",
"city": "Buffalo",
"state": "NY",
"postal_code": "142143001",
"country_code": "US",
"telephone_number": "716-829-6130",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "POKU",
"first_name": "JUDE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-05-20",
"last_updated": "2023-12-29",
"certification_date": "2023-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NV",
"license": "19315",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MO",
"license": "2023039360",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1205215415",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "19315",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.