Individual provider Active NPI

Chinemere Ernest Ekezie

  • General Practice Physician
  • Brooklyn, NY
National Provider Identifier
1285406421
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
P125305 Issued in NY
Practice address
380 Henry St
Brooklyn, NY 11201-6048
Phone
(718) 855-6789
NPI assigned
Oct 23, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X P125305 NY Primary

Addresses

Primary practice location

380 Henry St
Brooklyn, NY 11201-6048

Mailing address

2244 Jackson Ave
Long Island City, NY 11101-9400
Phone (469) 969-9190

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20240607000129 NY Practitioner - General Practice 1254873185

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P125305NYMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1698019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1285406421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2244 JACKSON AVE",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111019400",
            "telephone_number": "469-969-9190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 HENRY ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112016048",
            "telephone_number": "718-855-6789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKEZIE",
        "first_name": "CHINEMERE",
        "middle_name": "ERNEST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-23",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "P125305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.