Active NPI
Chigozie Meziri Maduchukwu
- Physician Assistant
- Vallejo, CA
National Provider Identifier
1235917832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA66315
- Practice address
- 365 Tuolumne St
Vallejo, CA 94590-5700 - Phone
- (707) 553-5509
- NPI assigned
- Sep 15, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA66315 | CA | Primary |
Addresses
Primary practice location
365 Tuolumne St
Vallejo, CA 94590-5700
Mailing address
3200 Northwood Dr Apt 250
Concord, CA 94520-4523
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250807001845 | CA | Order and Referring Only - Physician Assistant | 5799283982 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA66315 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1768953600000",
"number": "1235917832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 NORTHWOOD DR APT 250",
"city": "CONCORD",
"state": "CA",
"postal_code": "945204523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "365 TUOLUMNE ST",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945905700",
"telephone_number": "707-553-5509"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADUCHUKWU",
"first_name": "CHIGOZIE",
"middle_name": "MEZIRI",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-09-15",
"last_updated": "2026-01-21",
"certification_date": "2026-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA66315",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vallejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.