Irene Enjema Ekobena, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

10642 Issued in MN

Practice address

464 2ND St Ste 204
Excelsior, MN 55331-2015

Phone

(612) 787-8408

Fax

(612) 567-8935

NPI assigned

Aug 21, 2023

Last updated

Feb 20, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rehabilitation Medicine Associates LLCGroup PAC ID 9335465558, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Rehabilitation Medicine Associates, LLC

  • Physical Medicine & Rehabilitation Physician
  • Excelsior, MN
  • NPI 1093103145
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1255115473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "464 2ND ST STE 204",
            "city": "EXCELSIOR",
            "state": "MN",
            "postal_code": "553312015",
            "telephone_number": "612-787-8408",
            "fax_number": "612-567-8935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "464 2ND ST STE 204",
            "city": "EXCELSIOR",
            "state": "MN",
            "postal_code": "553312015",
            "telephone_number": "612-787-8408",
            "fax_number": "612-567-8935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKOBENA",
        "first_name": "IRENE",
        "middle_name": "ENJEMA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-21",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "10642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryan Dorn, DPT
• Hillary Duarte
• Rhea Marie Dykoski, L.AC., DIPL.O.M.
• Eagle Medical PA
• Virginia G Ehrman, LP
• Empower Chiropractic and Wellness Center P.L.L.C.
• Brian Entinger, PHARM. D.
• Estates at Excelsior LLC
• Excelsior Eyecare, PLLC
• Excelsior Family Dental

• Gerontology Nurse Practitioner in Excelsior, MN
• Providers in Excelsior, MN by specialty
• Gerontology Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; 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.

Verify at the official NPI Registry.