Individual provider Active NPI

Eziuche M Nwakanma, M.D,

  • Emergency Medicine Physician
  • Webster, TX
National Provider Identifier
1225290091
Registry record updated Sep 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
T2029 Issued in TX
Practice address
200 Blossom St
Webster, TX 77598-4204
Phone
(832) 632-6500
Fax
(832) 632-6855
NPI assigned
Jul 1, 2008
Last updated
Sep 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 262978 NY
Emergency Medicine Physician 207P00000X T2029 TX Primary

Addresses

Primary practice location

200 Blossom St
Webster, TX 77598-4204

Mailing address

11620 190TH St
Saint Albans, NY 11412-3132

Other practice location 1

11620 190th St
Saint Albans, NY 11412-3132
Phone (917) 399-8589

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, 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
I20120307000357 NY Practitioner - Emergency Medicine 0840459012 Reassigns benefits to 3 organizations
I20210927001346 TX Practitioner - Emergency Medicine 0840459012 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Travis County Emergency Physicians PAGroup PAC ID 0840289468, 289 clinicians

Practice addresses (Care Compare)

6565 Fannin St
Houston, TX 77030-2703
Phone (713) 790-3311

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Newyork-Presbyterian/Queens Emergency Medicine CurrentSince Feb 12, 2012 Accepting new patients
Orange Emergency Services PC Emergency Medicine CurrentSince Jan 1, 2012 Accepting new patients
Sullivan Emergency Services PC Emergency Medicine CurrentSince Jan 1, 2012 Accepting new patients
Newyork-Presbyterian-Queens CurrentSince Feb 12, 2012 Accepting new patients
Usacs Integrated Acute Care Services of Texas, PLLC CurrentSince Dec 6, 2024 Accepting new patients
Travis County Emergency Physicians PA Emergency Medicine CurrentSince Jul 19, 2023 Accepting new patients
Methodist Health Centers Past Accepting new patients

Locations

17561 Hillside Ave
Ste 402
Jamaica, NY 11432
Phone (718) 670-1021

707 E Main St
Middletown, NY 10940
Phone (845) 333-1000

7900 Ranch Road 1826
Austin, TX 78737
Phone (512) 324-5305

4401 Garth Rd
Baytown, TX 77521
Phone (281) 420-8500

18220 Tomball Pkwy
Houston, TX 77070
Phone (281) 477-0000

18500 Katy Fwy
Houston, TX 77094
Phone (281) 206-9020

2615 Southwest Fwy
Ste 140
Houston, TX 77098
Phone (713) 441-2779

260 Cully Dr
Kerrville, TX 78028
Phone (830) 258-7323

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

1310 E League City Pkwy
League City, TX 77573
Phone (346) 427-5050

11525 Broadway St
Pearland, TX 77584
Phone (713) 363-8020

8200 Highway 6
Sienna Plantation, TX 77459
Phone (713) 441-3724

16655 Southwest Fwy
Sugar Land, TX 77479
Phone (281) 274-7117

17201 Interstate 45 S
The Woodlands, TX 77385
Phone (936) 270-2000

3759 FM 1488 Rd
Ste 500
The Woodlands, TX 77384
Phone (832) 299-2500

6565 Fannin St
Va Hospital, TX 77030
Phone (713) 394-6000

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

Hospital & facility affiliations 1

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": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1225290091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11620 190TH ST",
            "city": "SAINT ALBANS",
            "state": "NY",
            "postal_code": "114123132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BLOSSOM ST",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984204",
            "telephone_number": "832-632-6500",
            "fax_number": "832-632-6855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11620 190th St",
            "address_purpose": "LOCATION",
            "city": "Saint Albans",
            "state": "NY",
            "postal_code": "114123132",
            "country_code": "US",
            "telephone_number": "917-399-8589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NWAKANMA",
        "first_name": "EZIUCHE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-01",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "262978",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "T2029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, TX

Sources for this page

Verify at the official NPI Registry.