Individual provider Active NPI

Nkemdilim Obiorah Ezeife, M.D.

  • Hospitalist Physician
  • Ridley Park, PA
National Provider Identifier
1225326994
Registry record updated Nov 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD450603 Issued in PA
Practice address
175 E Chester Pike
Ridley Park, PA 19078-2212
Phone
(610) 595-6000
NPI assigned
Jul 15, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X MD450603 PA Primary

Addresses

Primary practice location

175 E Chester Pike
Ridley Park, PA 19078-2212

Mailing address

30 Medical Center Blvd
Suite 404
Upland, PA 19013-3955
Phone (610) 619-8590

Other identifiers 1

IdentifierTypeStateIssuer
MD450603OtherPAPA MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20141211000726 PA Practitioner - Internal MedicinePractitioner - Hospitalist 1759603285 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect Health Access Network, Inc. Hospitalist CurrentSince Jul 1, 2016 Accepting new patients
Prospect Health Access Network, Inc. Current Accepting new patients
Prospect Health Access Network, Inc. CurrentSince Jul 1, 2016 Accepting new patients
Regional Health Services Inc Hospitalist CurrentSince Sep 1, 2017 Accepting new patients

Locations

1 Medical Center Blvd
Ste 301
Chester, PA 19013
Phone (610) 566-6744

1 Medical Center Blvd
Chester, PA 19013
Phone (610) 447-6666

3406 Peach St
Erie, PA 16508
Phone (814) 877-5381

201 State St
Erie, PA 16550
Phone (814) 877-2137

2 Hot Metal St
#One
Pittsburgh, PA 15203
Phone (412) 432-5864

175 E Chester Pike
Ridley Park, PA 19078
Phone (610) 595-6000

100 W Sproul Rd
Ste 123
Springfield, PA 19064
Phone (610) 619-8281

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1310688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415836800000",
    "number": "1225326994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 MEDICAL CENTER BLVD",
            "address_2": "SUITE 404",
            "city": "UPLAND",
            "state": "PA",
            "postal_code": "190133955",
            "telephone_number": "610-619-8590",
            "fax_number": "610-619-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 E CHESTER PIKE",
            "city": "RIDLEY PARK",
            "state": "PA",
            "postal_code": "190782212",
            "telephone_number": "610-595-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZEIFE",
        "first_name": "NKEMDILIM",
        "middle_name": "OBIORAH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-15",
        "last_updated": "2014-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "MD450603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA MEDICAL LICENSE",
            "identifier": "MD450603",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridley Park, PA

Sources for this page

Verify at the official NPI Registry.